In the case of substances with a strong nephrotoxic (kidney-damaging) effect, uncontrolled intake of medication can lead to pronounced kidney damage and even acute or chronic kidney failure. Depending on the extent of kidney damage caused by the medication taken, the disease can usually be treated well if therapy is started early.
What is Kidney Damage from Drugs?
Kidney damage caused by drugs or as a result of taking drugs that damage the kidneys is part of the disease spectrum of toxic nephropathy. Toxic nephropathy is chronic or acute damage to the kidneys caused by noxae (disease-causing substances). See etaizhou for What does CS Mean.
Kidney damage caused by medication usually manifests itself in acute nephritis, which is caused by hypersensitivity reactions of the kidneys to the medication taken and is associated with symptoms typical of allergies such as joint and limb pain, skin rash and fever.
In addition, the urinary fluid can have a bloody and cloudy discoloration, as proteins and red blood cells can no longer be filtered out as a result of the impairment of kidney function. As the disease progresses, hypertension (high blood pressure), increased urine concentration, edema (water retention) in the legs and arms, sallow gray skin, insomnia, cardiac arrhythmia, nervousness and difficulty concentrating and bad breath (foeter uraemicus) are further symptoms of kidney damage caused by medication.
Causes
Almost all medications have nephrotoxic properties, especially when taken long-term and/or in high doses. For this reason, blood values and kidney function are regularly checked for a large number of medications.
Since the kidneys play a decisive role in detoxification and the breakdown of pathogenic substances, medication often represents an additional burden for the kidneys, which are also heavily supplied with blood, which are therefore particularly exposed to the substances themselves and their breakdown products.
If the concentration of the drugs rises above the water reabsorption rate in the blood, there is an increased concentration of these substances in the kidneys, which causes the characteristic damage to the kidney tissue.
In addition, the breakdown products of certain drugs are toxic substances that cause additional damage to the kidneys. In addition to painkillers, drugs that can cause kidney damage include chemotherapeutic agents, substances that regulate blood pressure, diuretics, antibiotics , and drugs for rheumatism and gout.
Symptoms, Ailments & Signs
Medications can promote a variety of kidney diseases or even cause kidney damage themselves. Possible symptoms of a drug-induced kidney disorder include tiredness, exhaustion, lethargy and a general feeling of illness. Typical physical symptoms are water retention and shortness of breath.
Due to the restricted kidney activity, urine excretion is also reduced, which can result in fever and urinary tract infections. Cardiovascular problems such as drop in blood pressure, tachycardia and cardiac arrhythmia can also occur. Externally, kidney disease can be recognized by paleness and a generally sickly appearance.
Hair loss can also occur. Some sufferers experience tremors or even convulsions. The exact symptom picture depends on the triggering medication and the type of kidney damage. What kidney damage has in common is that it greatly reduces the patient’s quality of life and well-being.
Typically, severe pain and a variety of other symptoms occur, which become worse as the disease progresses. If the offending drug is not stopped, kidney failure will eventually result and the patient will die. By switching to a harmless preparation, the occurrence of further symptoms can be prevented. Depending on whether permanent damage has already occurred, full recovery may also be possible.
Diagnosis & History
Based on the currently present symptoms, the first indications of kidney damage caused by medication can be diagnosed. The diagnosis can be backed up by a blood and urine analysis, which allows statements to be made about kidney function and existing limitations.
If kidney damage or impairment of kidney function is present, the concentration of the substances excreted in the urine (creatinine, urea) in the blood and urine is increased. In addition, further examinations such as quantitative and qualitative functional tests to determine the extent of renal insufficiency (kidney weakness) are indicated.
With the help of imaging procedures (sonography, computer, nuclear spin tomography, scintigraphy), a morphological assessment of the kidneys and the urinary tract is possible. In the case of kidney damage caused by medication, the course and prognosis depend decisively on the extent of the impairment present.
While acute kidney damage can usually be treated well by stopping the medication, pronounced impairment of the kidneys after long-term use of nephrotoxic drugs are often irreversible.
Complications
Both the blood purification and the body’s salt and water balance are disturbed due to the damaged kidneys. Various organs are thus restricted in their function. As a result, despite treatment, various health-endangering complications can arise.
Since the body produces less urine, excess water and salts can no longer be excreted sufficiently. Therefore, blood pressure rises. Due to the reduced urine output, the body stores fluid. edema develops. Fluid retention primarily occurs in the legs. Edema can occur in any part of the body. In the worst case, fluid builds up in the lungs (pulmonary edema).
Pulmonary edema manifests itself as a white and foamy cough secretion and can lead to severe shortness of breath. Since the cardiovascular system is damaged, pronounced calcification of the arteries and heart valves develops. The development of heart valve defects and cardiac insufficiency is thus favored. The hardened arteries can also cause a heart attack or stroke.
As the kidneys progressively lose their ability to excrete potassium, this can lead to increased levels of potassium in the blood (hyperkalemia). Indicators of increased potassium levels are a slow heartbeat, dizziness, brief loss of consciousness, muscle weakness and tingling sensations. High levels of potassium can lead to cardiac arrhythmia and cardiac arrest.
The excess water associated with high potassium levels can also trigger a stroke or heart attack. Frequently occurring complications are also neurological disorders. Such disorders of the nervous system are expressed, for example, by tiredness, memory, concentration, perception and sleep disorders, muscle weakness, itching and disorientation. Due to the weakening kidney function, the body only produces small amounts of blood-forming hormones.
Therefore, the development of anemia is favored (anaemia). This can manifest itself in reduced physical resilience, tiredness and paleness of the skin. In addition, declining kidney function is accompanied by disturbances in bone metabolism. For this reason, bone fractures, bone, muscle and joint pain are increasing.
The damaged kidney increases the phosphate level in the blood. High phosphate levels trigger itching, bone and muscle pain. The elevated levels also intensify the risk of heart attack and stroke. Since the body absorbs less protein with decreasing kidney function, malnutrition in the patient can also occur.
When should you go to the doctor?
Kidney damage caused by medication is always a case for the doctor. The earlier the damage to the kidneys is noticed, the easier it is to treat, depending on the type of drug, dose and length of time it is taken. At best, kidney damage that is detected early can be completely reversed by medication – but the prerequisite for this is that the person concerned seeks medical treatment as quickly as possible and does not delay the necessary doctor’s appointment. If the harmful drug is taken on the doctor’s prescription, the regular check-ups must be strictly observed, since the doctor also checks kidney values and can notice if damage to the kidneys has occurred.
If the patient takes a drug that can damage the kidneys without a doctor’s recommendation, he must read the information on the package leaflet before taking it and pay attention to possible symptoms of kidney damage while taking it. If these occur, it is advisable to see a doctor even if they are not perceived as severe or stressful or if they gradually improve on their own. Only a doctor can tell whether they are harmless or whether medication has actually caused kidney damage – so possible symptoms should always be taken seriously while taking medication.
Treatment & Therapy
In the case of kidney damage caused by drugs, the therapeutic measures largely depend on the extent of the specific damage and whether the kidneys are impaired acutely or chronically.
In the case of acute kidney damage, the medication that caused it is often discontinued as a first step. In some cases, hemodialysis is also carried out, through which the kidney function is temporarily replaced until the kidneys have normalized and the excess urinary substances and electrolytes are filtered out of the blood of the person concerned.
Hemodialysis also supports circulatory stabilization and promotes kidney blood flow. During therapy, renal function values should be checked regularly and the treatment adjusted accordingly if they deteriorate. In addition, dietary measures such as a diet low in salt, protein, phosphate and potassium are recommended to support the treatment of kidney damage.
Furthermore, the daily amount of liquid should be adjusted to the current capacity of the kidneys. If anemia (low blood count) is diagnosed, the hormone erythropoietin, which is normally produced in healthy kidneys, is used to stimulate the synthesis of red blood cells in the bone marrow.
In a more advanced stage of the disease with irreversible damage to the kidneys as a result of taking the medication, permanent dialysis or, if necessary, a kidney transplant may be necessary.
Outlook & Forecast
Kidney damage from medication leads to permanent damage to the organ. The tissue is irreparably damaged and thus triggers impairments in the functioning of the kidneys. A recovery is not achieved with these patients, since the self-healing powers of the human organism do not allow regeneration of organic tissues.
There is a need for long-term therapy, in which medically controlled medication is administered in order to alleviate the health impairments. The aim is to achieve an improvement in the overall situation and to avoid an increase in existing complaints. Some people need dialysis because of the severity of the disease. This is often the only way to reduce existing symptoms.
The necessary treatment methods for kidney damage have a strong impact on everyday life. The physical and emotional stress is immense for many people due to the necessary therapies. There is therefore an increased risk in these patients for the development of a secondary disease and a severe reduction in general well-being. This circumstance must be taken into account when making the overall prognosis.
If the kidney damage caused by the medication taken is very severe, a donor organ may be necessary to avert a possible danger to life. A transplant is associated with numerous complications that must be considered.
Prevention
The most effective measure to prevent kidney damage from medications is careful handling of these potentially nephrotoxic substances. The medications that require special caution include painkillers such as paracetamol, non-steroidal anti-inflammatory drugs (acetylsalicylic acid) and ibuprofen.
Aftercare
If kidney damage is caused by medication, follow-up examinations and, if necessary, follow-up treatments are necessary. Depending on the damage, outpatient follow-up care by a nephrologist is advisable. This is also the case if the kidney function is largely restored after treatment of the kidney damage has been completed.
This limits the risk that can develop as a result of damage to the kidneys. Appropriate treatment approaches are possible through early detection as part of this follow-up care. Complaints that point to kidney diseases or urinary tract diseases are diagnosed promptly. With early detection, diagnostic and therapeutic measures can prevent complicated, acute kidney damage.
Annual check-ups are recommended. In this context, the family doctor carries out examinations of the patient. In addition to determining the urine status, blood counts are carried out. In addition, the patient should present to the specialist in urology at least once a year. If normal kidney function is confirmed in the course of the follow-up care, the intervals between the examinations will be extended by the doctor treating you.
Follow-up care for the patient includes a generally healthy lifestyle with a balanced diet, drinking enough and exercising. If the kidney damage caused by medication is very advanced and very serious, temporary or permanent dialysis treatment is also necessary after medical follow-up clarification.
You can do that yourself
People who have suffered kidney damage from medication should consult their doctor to clarify side effects for each of the prescribed drugs. In addition, the package leaflet must be read carefully. If you have any questions or are unclear, the pharmacist can also provide missing information. Depending on the existing kidney damage, an individual therapy plan is drawn up, which the person concerned should adhere to. Sufficient fluids should be consumed and heavy physical activity should be avoided. As soon as irregularities are noticed due to overexertion, rest and protection are necessary.
A good and restful night’s sleep is important for maintaining well-being. Sleep hygiene needs to be optimized and disruptive factors eliminated. The diet should be adapted to the needs of the organism. The supply of sufficient vitamins, trace elements and nutrients is necessary to stabilize the immune system. Pollutants such as nicotine, alcohol or drugs should always be avoided. They worsen the general state of health and can contribute to further impairments in the quality of life.
Despite the damage to the kidneys, regular light physical activity and daily exposure to the outdoors are recommended. Yoga or meditation help to build up inner strength and contribute to harmonizing the emotional state. Overall, this results in an increase in well-being.
