I encounter quite a good number of patients with Acute Kidney Injury (AKI) which developed subsequently following ingestion or parenteral intake of commonly used (ODC) NSAIDs. These are happening particularly in elderly patients with generalised bodyache/old or recent fractures & of course, with some old-age co-morbidity.
Dear Rabiul,
the simple answer is to avoid them as much as possible, particularly in the elderly and in patients with other acute or chronic co-morbidities. If they really are necessary only give them for a very short time. Ensure that patients are well hydrated, have no concomitant (uro-) sepsis, don't take other potentially nephrotoxic drugs, are not in heart failure, have no diabetic nephropathy or other renal disease.
Alternative drugs but more importantly non-pharmacological therapies should really be used more.
Patients, as well as their relatives and caregivers need to be made aware of the risks and that drugs that are easily available over the counter and are broadly advertised/pushed by industry can cause significant morbidity and mortality.
Best wishes,
Immo
The best way to prevent AKI induced by NSAIDs is to avoid the usage. There are other non - nephrotoxic analgesics that can be recommended to alleviate the pain. But despite Kidney disease patients if compelled to receive NSAIDs the best options are
1) To choose the least nephrotoxic NSAID at the lowest dose ( Piroxicam 10 - 20 mg )
2) Hydrate the patient adequately
3 ) Avoid combining other Nephrotoxic agents
4) Non - Pharmacological methods to alleviate pain should be encouraged.
I agree with you that NSAIDS are important cause of AKI . It is preferable to avoid them in hypovolemic disorders , such as diarrhea & blood loss due to trauma & when using diuretics for diseases causing oedema ( cardiac failure , chronic liver disease & renal disease ) .NSAIDS are not to be combined with ACEI/ARB's . It should be definitely avoided in renal diseases ( CKD ) & always check serum creatinine before starting NSAIDS . In young patients with no co morbid Illness , NSAIDS can be used for arthritis & pain relief .
- Badges
- Science topic
- Similar topics
- Design
- Architecture