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.
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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) disease.
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 donors.
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 dialysis.
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 out.
Finding a donor match
Being accepted for kidney transplantation is not an easy feat. There are currently over 100,000 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.
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