Written by Sherryl Mitchell Hernandez, MD, Nephrologist, Nephrology Associates, Emerald Coast Medical Association.

NSAIDs and Your Kidneys: What to Know Before Your Next Ibuprofen

Ibuprofen and other nonsteroidal anti-inflammatory drugs, commonly called NSAIDs, sit in nearly every medicine cabinet. They are easy to reach for, and for occasional aches and pains, they can be genuinely helpful. As a nephrologist, though, I see the other side of that convenience more often than most people realize.

NSAIDs work in part by narrowing blood flow to the kidneys. Used occasionally, this rarely causes a problem. Used regularly, especially at high doses or over long periods, it can increase systemic blood pressure and decrease blood flow within the kidney itself, contributing to kidney damage that builds slowly and often without warning.

This matters most for people who already have reduced kidney function, diabetes, high blood pressure, or heart failure, and for anyone taking NSAIDs daily for chronic pain rather than occasional use. I regularly see patients whose kidney function has declined in part because of long-term, high-dose NSAID use for pain that was never fully addressed with their doctor.

None of this means NSAIDs are forbidden. It means they deserve the same respect as any other medication. If you find yourself taking ibuprofen or a similar medication several times a week for ongoing pain, that is a conversation worth having with your doctor rather than a habit to continue on your own. There are often other options for chronic pain management that carry less risk for your kidneys, and if you do have kidney disease, your doctor can help you find pain relief that does not put your kidney function at risk.

The simplest rule I give my patients: an occasional dose for an occasional headache is very different from a daily habit for chronic pain. If you are unsure which category you fall into, ask.

Dr. Mitchell Hernandez is an Internal Medicine board-certified and nephrologist with Nephrology Associates in Panama City, Florida, and a member of the Emerald Coast Medical Association. Hear more from Dr. Mitchell Hernandez on Episode 23 of Emerald Coast Medical Mastery.

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