Henrich WL, Agodoa LE, Barrett B, Bennett WM, Blantz RC,
Buckalew VM, et al.
Analgesics and the kidney: Summary and recommendations to the
Scientific Advisory Board of the NKF from an Ad Hoc Committee of the
Am J Kidney Dis
(Jan) 27:162-164 1996
Recommendations of the National Kidney Foundation on Analgesics and the
On June 9 to 11, 1995, the National Kidney Foundation convened an expert
investigators and clinicians to consider and develop recommendations on the
analgesic-related kidney disease. The following recommendations were
the January 1996 issue of the American Journal of Kidney Disease.
Aspirin as a single analgesic.
- In patients with normal renal function, aspirin should not be taken
hours of ingestion of any nonnarcotic NSAID, and vice versa.
- In patients with impaired renal function, acute glomerulonephritis,
sodium depletion, cirrhosis
with ascites, and in children with congestive heart failure, aspirin should
be avoided. If use is
necessary, careful monitoring of renal function should be undertaken. This
would consist, at the
least, of following the serum creatinine concentration at baseline and
Acetaminophen as a single analgesic.
- Acetaminophen remains the nonnarcotic analgesic of choice for
episodic use in
patients with underlying renal disease.
- The habitual consumption of acetaminophen should be discouraged.
- The availability of analgesic mixtures as an over-the-counter
produce should cease.
- Analgesic mixtures as prescription products should have a label warning
of the increased
prevalence of kidney injury and chronic renal failure associated with
habitual use of analgesic
- There should be an explicit label warning patients taking over-the-
NSAIDs of the potential renal risks of consuming the drugs.
- The use of NSAIDs during pregnancy should be avoided.
- The prolonged regular use of NSAIDs should be discouraged.
- Combinations of NSAIDs with other analgesics or caffeine should be
prospectively evaluated for
renal safety before the release of any such combination.
(George R. Aronoff, M.D.)