Severe damage can require diaslysis or even a transplant
Kidneys are essential, yet they are easy to damage and difficult to replace.
Typically, everyone is born with two kidneys. These bean-shaped
organs, about the size of a fist, are located on both sides of the
spine, just underneath the ribs on your lower back.
Your kidneys serve several vital functions. They help get rid of
waste products through urination, and they play a significant role in
maintaining your blood pressure, help make vitamin D that keeps your
bones healthy, make hormones vital in the production of red blood cells,
and they maintain a healthy fluid balance in your body.
Surprisingly, in addition to disease, some very common medications
can be hard on kidneys and interfere with their ability to function
properly. Prolonged use of these medications can permanently damage your
kidneys. This damage can result in a need for dialysis and, in extreme
cases, may even require a kidney transplant.
Currently, 31 million Americans (10 percent of the population) are
afflicted with kidney disease. Kidney disease is the ninth leading cause
of death in the United States.
Non-steroidal anti-inflammatory drugs (NSAIDs)
These seemingly harmless, yet readily available medications can cause
severe damage to kidneys if they are used for a long time, or at high
doses. This includes over-the-counter medicines like Tylenol, ibuprofen,
and aspirin. Also, prescription NSAIDs can cause similar problems. The
misuse and long-term use of pain medications is responsible for up to 10
percent of kidney failure cases annually.
Antibiotics can affect the kidneys in several ways. They can damage
kidney cells; they can form crystals that are deposited in kidneys and
prevent smooth urine flow; or people can develop allergies to the
medications that damage the kidneys if the antibiotics are used over an
extended period or administered at high doses.
Diuretics (water pills)
These medicines are used to help control blood pressure and some
types of swelling, especially in the lower legs. It is a delicate
balance. They can help the body get rid of unwanted water, which reduces
swelling and blood pressure, but if they eliminate too much water, the
body can become dehydrated. Being dehydrated over an extended period can
be damaging to your kidneys.
Acid controlling medications
Many medications used to treat heartburn and acid reflux have also
been shown to be damaging to kidneys if used for an extended
period. Some medicines are better for your kidney health than others. If
you are taking medications to control acid reflux, heartburn or stomach
ulcers, make sure your doctor is monitoring your kidneys regularly, or
ask your doctor if there are medications that will help you that are not
hard on your kidneys.
Vitamins and supplements
Some supplements, especially those containing creatine, may not be
healthy for your kidneys. Be sure to review all medications with your
doctor at every doctor’s visit, including vitamins and supplements and
over-the-counter medications, to make sure they are appropriate.
Laxatives, especially ones that contain oral sodium phosphate (OSP),
if used over an extended period, can hurt your kidneys. Be careful if
you repeatedly need laxatives. Discuss with your doctor safe ways to
maintain proper bowel health.
When kidneys are already damaged, certain drugs can make them worse
or lead to kidney failure. If you have kidney disease, you must be
extremely careful with all medicines. Many that would typically have
little or no effect on your overall health can cause unexpected damage
to you because of your kidneys’ already compromised state.
In addition to the medicines previously discussed, these include
medications that treat cholesterol, viral infections, diabetes and
fungal infections, or are used for specific imaging studies.
Talk to your doctor before taking cholesterol or diabetes medication,
antacid medicine for an upset stomach, or antimicrobial meds, like
antifungal and antiviral drugs. Your doctor may recommend a different
test or medicine, or a smaller dose of medicine that is safer for you.
Kidney dialysis and transplantation
If kidneys lose their ability to filter fluids and remove dangerous
waste products, these products can build up inside us and eventually
lead to death. This situation is called end-stage kidney (renal)
Diseases, medications or genetic abnormalities can cause end-stage
renal disease. When this happens, a person must undergo dialysis – some
several hours per day – to remove the toxins and stay alive.
An alternative to dialysis is kidney transplantation. This occurs
when a healthy kidney is surgically implanted from a donor into a person
with non-functioning kidneys. The kidney can come from a live or
deceased donor. One-third of all donated kidneys come from living
Only one kidney is needed to do an adequate job. This “one-kidney
requirement” makes living kidney donation a very real option. Kidney
transplantation can be an acceptable alternative to a lifetime of
Approximately 20,000 transplants occur every year in the U.S.
Transplantation offers several benefits, including a higher quality of
life, lower treatment cost in the long run, fewer dietary restrictions,
and a lower mortality rate. Kidney transplantation also carries
significant risk. This includes the risk of surgery, the risk of kidney
rejection, and the risk of the side effects of the medications used to
prevent organ rejection.
After careful evaluation, one may be considered appropriate for
transplantation. There are certain situations, however, such as age and
several health status conditions, which can rule kidney transplantation
Finding a donor match
Being accepted for kidney transplantation is not an easy feat. There
are currently over 100,00 people waiting for a kidney transplant in the
United States, and 100 people are added to the list every day.
Once accepted, a suitable match must be located from a donor.
Surprisingly, family members are not always good donors. Finding a
compatible kidney donor can take weeks to months to several years. The
average wait for a compatible kidney is 3.5 years. Unfortunately, 14
people die every day waiting for a kidney transplant in America.
Kidney transplantation is not a cure. After a successful kidney
transplant, a lifetime of care must be initiated; nevertheless, kidney
transplantation can be lifesaving.
Electing kidney transplantation is a very personal decision that
comes with risks and benefits. The decision must be considered very
carefully by all involved including the patient, the patient’s family,
trusted advisers and physician.
If you are interested in becoming a kidney donor, start the discussion with your doctor.