How Much Alcohol Is Too Much
When experts talk about one drink, they are talking about one 12-ounce bottle of beer, one glass of wine , or one shot of “hard liquor.”
Having more than three drinks in a day for women, and more than four drinks in a day for men, is considered “heavy” drinking. The kidneys of heavy drinkers have to work harder. Heavy drinking on a regular basis has been found to double the risk for kidney disease.
Binge drinking can raise a person’s blood alcohol to dangerous levels. This can cause a sudden drop in kidney function known as “acute kidney injury.” When this happens, dialysis is needed until a person’s kidney function returns to normal. Acute kidney injury usually goes away in time, but in some cases, it can lead to lasting kidney damage.
Some people should not drink at all. Ask your healthcare provider if it is safe for you to drink, especially if you have a medical condition or take medicines that might be affected by using alcohol. Women, older people, and those with smaller bodies should be especially careful. Of course, pregnant women are advised not to drink alcohol.
Is Aspirin Safe For Regular Use
When taken as directed, regular use of aspirin does not seem to increase the risk of kidney disease in people who have normal kidney function. However, taking doses that are too large may temporarily- and possibly permanently- reduce kidney function. In people with kidney disease, aspirin may increase the tendency to bleed. People who already have reduced kidney function, or other health problems such as liver disease or severe heart failure, should not use aspirin without speaking to their doctor.
Kidney Impairment Can Be Costly
Although renal impairment is often reversible if the offending drug is discontinued, the condition can be costly and may require multiple interventions, including hospitalization, Dr. Naughton explained. To help you avoid getting to that point, we learned about medications that commonly cause kidney damage from Rebekah Krupski, PharmD, RPh, pharmacy resident at the Cleveland Clinic and clinical instructor of pharmacy practice at Northeast Ohio Medical University.
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Causes Of Kidney Stones
When there is an imbalance of water, salt, and mineral water in your urine, you may begin developing small crystals that turn into stones within your kidneys. As the stones grow in size, they can lead to severe pain and other symptoms. But, before enlarging, theyre often resolved without any medical interference.
Kidney stones typically occur when youre drinking less water than what your body needs. People in warmer climates are often more susceptible, as they sweat more and require more water to stay hydrated. But, other factors can increase your risk of developing kidney stones including:
- High blood pressure
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Treatment Options For Kidney Stones
Some stones are released into the urinary tract without any signs or symptoms. On the contrary, some stones are big enough to cause excessive pain, and others can be too big to pass on their own without medical assistance. 90% of kidney stones that are 5 mm or smaller pass on their own without medical attention, but larger stones require medical aid in order to pass more than 50% of the time. Kidney Stone Overview
In these more extreme cases, Extracorporeal Shock Wave Lithotripsy is a common treatment for kidney stones. The process can cause some pain, and even bruising or bleeding, but it effectively uses energy shock waves to break down large kidney stones into smaller pebbles, making it possible for them to pass. Along with muscle relaxers to help dull the pain, your Doctor can also prescribe an alpha-blocker type medication to relax ureter walls, allowing the stone to more easily free itself. Once your kidney stone has passed, your doctor can run tests on the actual stone to uncover the predominant chemical make up.
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Where Do Kidney Stones Come From
Kidney stones form develop when certain substances, such as calcium, oxalate, and uric acid, become concentrated enough to form crystals in your kidneys. The crystals grow larger into stones. About 80% to 85% of kidney stones are made of calcium. The rest are uric acid stones, which form in people with low urine pH levels.
After stones form in the kidneys, they can dislodge and pass down the ureter, blocking the flow of urine. The result is periods of severe pain, including flank pain , sometimes with blood in the urine, nausea, and vomiting. As the stones pass down the ureter toward the bladder, they may cause frequent urination, bladder pressure, or pain in the groin.
If you experience any of these symptoms, see your primary care physician, says Dr. Eisner. He or she will likely perform a urinalysis and a renal ultrasound, abdominal x-ray, or CT scan to confirm kidney stones are the source of your pain and determine their size and number.
What Is Kidney Stone
Kidney stones are very common and are the result of calcium deposits from the diet that can obstruct the urinary tract. When the stones become too big, they cause severe pain on their back and side. Kidney stone treatment is available that can break up the stone into smaller and more passable pieces. Not all kidney stones need treatment. If it is a small stone, you might be able to get rid of it by passing it when you urinate. Kidney stone interventions depend on where and how big youre stone and what symptoms you have.
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How Do I Know If Analgesics Have Affected My Kidneys
Your doctor can check your kidneys by doing a simple blood test called a serum creatinine level. This test measures the amount of a waste product in your blood that is normally removed by your kidneys. If your kidneys are not working as well as they should, the creatinine level will be increased in your blood. The results of the serum creatinine test can be used to estimate your glomerular filtration rate . Your GFR number tells your doctor how much kidney function you have.
A urine test for the presence of protein may also be done. Persistent protein in the urine may be an early indication of kidney damage.
What Are Analgesics
Analgesics are medicines that help to control pain and reduce fever, and some types also decrease inflammation. Examples of analgesics that are available over the counter are: aspirin, acetaminophen, ibuprofen, Ketoprofen and naproxen sodium. Prescription strength pain medicines are also available. Some analgesics contain a combination of painkilling ingredients in one pill- such as aspirin, acetaminophen and caffeine- that have been linked to kidney disease. These are not as readily available as in the past.
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What Should You Do
- Do not take any medicine, drug or substance unless you are under a healthcare provider’s supervision.
- Do not take pills or substances given to you by a stranger or even a friend.
- If you do take a medication or other substance and feel ill, contact your healthcare provider immediately.
- If you need to have an imaging test or colonoscopy, let your healthcare provider know if you have kidney disease or are at risk for getting it.
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What Analgesics Are Safe For People Who Have Kidney Disease
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. However, kidney patients who need to use acetaminophen habitually should be supervised by their doctors and be sure to avoid drinking alcohol while on this medicine.
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Muscle Relaxant Use Common Among Patients On Hemodialysis And Is Associated With Falls
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The use of muscle relaxants is common among patients receiving hemodialysis and may increase the risk for altered mental status and falls, according to a study.
Patients receiving hemodialysis frequently report musculoskeletal pain and cramping but epidemiologic data regarding the prevalence, indications, and harms of muscle relaxant use in this population are lacking,Diana Mina, MD, of the department of medicine at the University of California, San Francisco, and the division of nephrology at San Francisco VA Medical Center, and colleagues wrote. Hemodialysis patients may be particularly predisposed to adverse effects from the use of muscle relaxants due to existing risk factors for falls and fractures, including dialysis-related hypotension, frailty, and chronic kidney disease-mineral and bone disorder. Furthermore, muscle relaxants and their metabolites may build up in the setting of decreased kidney function.
Primary outcomes of the study were time to first emergency department visit or hospitalization for altered mental status, fall or fracture. Secondary outcomes included death and composites of death with each of the primary outcomes.
Researchers found muscle relaxants were frequently prescribed, with 10% of the study population receiving muscle relaxants in 2011. The median duration of exposure to any muscle relaxant was 31 days.
Muscle Relaxers And Exercise
Although there is little in the way of literature advising for or against the use of muscle relaxers after your workout or while exercising, common sense should prevail. The most common side effect of muscle relaxers is drowsiness.
Exercising while feeling drowsy can be dangerous when using exercise equipment, such as treadmills, and can lead to injury. Drowsiness can also diminish the effectiveness of your workout by causing you to fatigue early.
Other side effects of muscle relaxers, such as dizziness and temporary loss of vision, may prove to be equally dangerous while working out. This can affect your balance and potentially result in head injuries.
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More Information On Medicines
We have a number of leaflets about the various medicines you may be prescribed depending on your condition:-
Note: these tablets can usually be stopped 6 months after a transplant.
Antibiotics used to treat haemodialysis line infections
- Gentamicin
Note: usually given as a single dose injection, then blood levels need to be measured.
Antibiotics to treat peritonitis in peritoneal dialysis patients
- Gentamicin
- Vancomycin
- Ciprofloxacin
Note: usually given as a course, either intravenously or in the dialysis fluid then blood levels need to be measured.
Drugs that lower blood pressure
- Calcium antagonists
- Beta-blockers
- ACE-inhibitors or ‘Prils’
- ARBs or ‘Sartams’
Note: all blood pressure tablets, if given in too high dosage, can cause low blood pressure and dizziness. ACE-inhibitors and ARBs can increase the potassium levels in the blood and cause or worsen kidney failure.
Water tablets
- Furosemide
- Metolazone
Note if given in too high dosage, these tablets can cause dehydration, low blood pressure and dizziness.
Spinolactone can cause the potassium levels in the blood to rise.
Drugs that control renal bone disease
Phosphate binders
Note: these tablets can also cause the calcium level in the blood to rise.
Cinacalcet
- This drug has the advantage of not raising calcium levels.
Drugs that increase your blood count
- Ferrous sulphate tablets
- Iron injection
- ESA injections
Drugs that control vasculitis
- Stronger: azathioprine
- Very strong: cyclophophamide
Drugs that thin your blood
- Aspirin
Muscle Relaxants Side Effects
Certain muscle relaxers, such as Flexeril, are known to have greater sedative properties than others, such as Skelaxin. Until you know how your body reacts to muscle relaxers, you should not exercise, drive or operate heavy machinery.
Talk to your doctor to determine whether exercise is appropriate for you if you are taking these medications. Other potential side effects of muscle relaxers may include gastrointestinal irritation, discoloration of urine, respiratory depression, dizziness and dry mouth.
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Methocarbamol May Interact With Other Medications
Methocarbamol oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.
To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs youre taking. To find out how this drug might interact with something else youre taking, talk to your doctor or pharmacist.
The Problem With Kidney Stones
Prof. Michael Cima, the studys senior author, notes, We think this could significantly impact kidney stone disease, which affects millions of people. Prof. Cima works with MITs Department of Materials Science and Engineering and the schools Koch Institute for Integrative Cancer Research.
The stones form when urine that usually washes crystals from the kidneys contains too much solid waste and not enough liquid to get the job done.
These crystals clump together, forming stones that painfully force their way down the narrow ureter, causing cramps and inflammation. Most pass within a few weeks, though the discomfort can be consistent and severe. Occasionally, large stones require surgical removal.
Because the Food and Drug Administration have yet to approve the use of any oral medications to widen the ureter and help the stones pass, doctors often simply prescribe pain relief medications.
Previously, other researchers have trialed ureter relaxants, but the drugs have not proved conclusively helpful.
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Kidney Stone Surgeries That Are Safe Only After Pregnancy Are:
- Stenting
A stent is placed in the ureter. The tube passes the urine which lessens the burden on the contraction of the urinary tract. The tube wont be removed till the end of pregnancy. This decreases the chances of kidney stones obstructing the ureter and causing pain. Stenting for kidney stones is a conventional surgical procedure that is invasive and the recovery period is long and painful for the patient.
- ESWL
ESWL uses ultrasonic pulses called shockwaves to break the stones. This surgery is not performed during pregnancy as it can cause fetal damage and death. But, shockwave lithotripsy is highly recommended for non-pregnant women to treat the complicated kidney stones.
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Common Muscle Relaxant Causes Severe Confusion In Patients With Kidney Disease
by University of Western Ontario
One in 25 patients with very low kidney function were admitted to hospital with severe confusion and other cognitive-related symptoms a few days after being prescribed a common muscle relaxant.
A new study from ICES Western, Western University and Lawson Health Research Institute has shown that patients with kidney dysfunction who were prescribed a high dose of the drug baclofen, were more likely to be admitted to hospital for disorientation and confusion, than those who weren’t prescribed the drug. Their results are being published on November 9 in the high impact journal, JAMA and are being presented at the same time at the American Society of Nephrology meeting in Washington, D.C.
“When we looked at people with low kidney function who received a high dose of baclofen from their prescriber, approximately one in 25 were being admitted to hospital with severe confusion, typically over the next few days, ” said Dr. Amit Garg, Professor at Western’s Schulich School of Medicine & Dentistry and Scientist at ICES and Lawson. “If you compare that to a group of people who had low kidney function who didn’t get baclofen, that risk is less than one in 500, so it’s quite a dramatic difference between the two groups.”
The research was initiated because of observations that nephrologists were noting in clinic at London Health Sciences Centre.
The authors also say patients should not stop their prescription medications without talking to their doctor.
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Medical Therapy Has Been Proposed For Decades
Medications that relax ureteral smooth muscle to help pass ureteral stones have been proposed for decades. Prior to 2000, however, only 1 randomized controlled trial of medical therapy for ureteral stones had been published. A subsequent meta-analysis found 9 studies and showed that medical therapy did increase the chances that a stone would pass. The Singh meta-analysis found 13 subsequently published studies and nearly tripled the number of patients evaluated.
Are Nsaids Safe To Take If You Have Kidney Disease
NSAIDs are usually safe for occasional use when taken as directed. However, if your doctor has told you that you have low kidney function, NSAIDs might not be right for you. These medications should only be used under a doctor’s care by patients with kidney disease. Also, they might not be the best choice for people with heart disease, high blood pressure or liver disease. Some of these drugs affect blood pressure control. High doses over a long period of time can also lead to chronic kidney disease and even progress to kidney failure.
For people without kidney disease, the recommended dose of aspirin can be safe if you read the label and follow the directions. When taken as directed, regular use of aspirin does not seem to increase the risk of kidney disease in people who have normal kidney function. However, taking doses that are too large may temporarily and possibly permanently reduce kidney function. In people with kidney disease, aspirin may increase the tendency to bleed.
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Impaired Thinking And Functioning
One very serious risk with regard to taking muscle relaxers is that they can impair your thinking and functioning, due to their sedative effect. It is common to feel drowsy as a result of taking these, as well as lightheaded, unsteady on your feet or less alert than normal. Impaired eyesight, thought process and decision making are common as well. As a result it is strongly advised to avoid driving or operating machinery while taking muscle relaxers.