Ibuprofen is harder on the kidneys than acetaminophen. Acetaminophen doesn't have the same effect on the COX pathway as ibuprofen. So kidney damage is much more rare. Kidney issues are typically only reported when a person has taken too much acetaminophen.
In fact, the National Kidney Foundation recommends acetaminophen as the pain reliever of choice for occasional use in patients who have underlying kidney disease. Although NSAIDs are more likely to cause kidney issues, Ibuprofen can still be used as long as it is not taken in excess.
Perneger et al investigated 716 patients with renal failure, and concluded that increased paracetamol use was associated with an enhanced risk of renal failure in a dose-dependent manner. Approximately 9% of renal failure cases were attributable to increased paracetamol use.
Acetaminophen remains the drug of choice for occasional use in patients with kidney disease because of bleeding complications that may occur when these patients use aspirin.
Taking too much ibuprofen or similar painkillers can damage kidneys, but a recent study has revealed some people at high risk are still being prescribed them. Research has found that prescriptions of non-steroidal anti-inflammatory drugs (NSAIDs) reduced over the two years before the pandemic.
However, taking doses that are too large (usually more than six or eight tablets a day) may temporarily and possibly permanently reduce kidney function.
This is called analgesic nephropathy. Painkillers that combine 2 or more medicines (such as, aspirin and acetaminophen together) with caffeine or codeine are the most likely to harm the kidneys.
A gel form of the prescription NSAID diclofenac (Voltaren Gel) is one option. Only a very small amount of the drug gets into the bloodstream, so it may be safe for your kidneys. However, topicals may not work well for hip pain, because the joint is too deep for the medication to penetrate.
Naproxen. Another anti-inflammatory drug, which works much like ibuprofen. Some studies show this may be a better choice than ibuprofen for people at risk for heart disease.
Paracetamol in standard doses is safe to take if you have kidney problems.
Acetaminophen is typically the safest painkiller available for use by kidney disease patients but should still be used under supervision by a doctor. Overuse of paracetamol can lead to liver failure.
ACE inhibitors and ARBs are two types of blood pressure medicine that may slow the loss of kidney function and delay kidney failure.
Ibuprofen constricts blood vessels to reduce pain and inflammation, but this also decreases renal blood flow. This reduction in blood flow can reduce your kidney function, and improper use of medication such as ibuprofen may impair the kidneys.
Weight loss and increased urine output may be signs your kidney function is returning.
Overall, treatment with oral nonsteroidal anti-inflammatory drugs is associated with a 1.7-fold increased risk of incident eGFR less than 60 mL/min/1.73 m2 and 1.9-fold increased risk of an eGFR decline of 30% or greater, a large study showed.
Antibiotics are the first line of treatment for kidney infections. The drugs used and the length of time of the treatment depend on your health and the bacteria found in your urine tests. Symptoms of a kidney infection often begin to clear up within a few days of treatment.
Time to Onset of Ibuprofen- and APAP-Associated Renal Injury
The average onset time of APAP-related kidney injury was 32.74 days, which was about a quarter of that of ibuprofen-related kidney injury (115.82 days).
Paracetamol is a widely known over-the-counter analgesic and antipyretic which, in acute poisoning usually causes liver damage, and less commonly damage to the kidney, heart, and pancreas.
You shouldn't take ibuprofen if you: have a history of a strong, unpleasant reaction (hypersensitivity) to aspirin or other NSAIDs. have a current or recent stomach ulcer, or you have had one in the past. have severe heart failure.