CDSCO Alerts on Painkiller Use: Kidney Risks Highlighted by Experts

Nephrologists have raised concerns regarding the self-medication habits among kidney patients, particularly the use of over-the-counter painkillers. This follows an advisory issued by the Central Drugs Standard Control Organisation (CDSCO) on September 22, warning of the potential risks associated with the indiscriminate use of non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics, which may contribute to chronic kidney disease. The warning comes amid increasing cases of kidney dysfunction among patients who frequently use painkillers without medical supervision. According to Sandeep Mahajan, a professor in the Department of Nephrology at the All India Institute of Medical Sciences (AIIMS) in Delhi, approximately 10-15% of his patients exhibit either primary or secondary associations with kidney disease due to painkiller use. The primary association indicates that the drugs directly cause harm, while the secondary association suggests that they exacerbate existing conditions. Mahajan described chronic use of analgesics as a precursor to ‘analgesic nephropathy,’ noting that these medications can impair kidney function in various ways, including reducing blood flow essential for waste filtration. Despite a single short course of such medication posing minimal risk to healthy individuals, repeated or prolonged use—especially among those with existing health conditions such as diabetes or hypertension—can lead to acute kidney injuries, he said. Soubeer Ghosh, a Consultant Nephrologist and Kidney Transplant Physician at PSRI Hospital, New Delhi, echoed these sentiments. He explained that frequent use of NSAIDs such as ibuprofen, diclofenac, and naproxen affects kidney function adversely, particularly when taken in high doses or without medical guidance. Ghosh explained that these drugs inhibit prostaglandins, compounds necessary for maintaining adequate blood supply to the kidneys, thus hindering their ability to effectively filter waste. Lovy Gaur, a Senior Consultant in Nephrology at Medanta in Noida, further elaborated on the dangers of self-medication, stating that patients often resume old prescriptions without evaluating their current condition or kidney function. High-risk groups include older adults and those suffering from pre-existing kidney disease, diabetes, hypertension, or heart failure. Patients facing dehydration from illnesses such as vomiting or diarrhoea are particularly susceptible to kidney damage. Gaur also warned that the concurrent use of certain medications like diuretics or specific antihypertensives increases the risk of kidney complications when NSAIDs are introduced. While assessing the correlation between rising kidney disease cases and medication use, Gaur noted that it should not be indiscriminately attributed to painkillers or antibiotics. The CDSCO advisory marks a crucial step in addressing these risks, but experts stress that public awareness and education about the dangers of self-medication are essential. Mahajan stated, “Public awareness is also very important,” emphasising that the advisory could serve to disseminate information about the associated risks to a broader audience. Ghosh cautioned that the assumption that over-the-counter medications are safe can lead to harmful outcomes, highlighting that their availability does not eliminate potential adverse effects.