Lack of Research in Renal Function for Drug Development & Effects of Certain Medications,
It is a fact that prescription drugs and medications can have a negative impact on the kidney. But the situation is even worse for people who need dialysis and have chronic kidney disease.
The kidney, after all, is responsible for removing toxins from the body which means its inability to perform its function to the utmost is detrimental to a person’s health and wellbeing. People who need dialysis started with chronic kidney disease (CKD) that progressed to end-stage kidney failure or end-stage renal disease (ESRD).
In America, more than 26 million have CKD but most of them don’t know it.
When sick, patients will often continue to take prescriptions and over-the-counter medications which can build up and cause harm due to a poorly working kidney. Until they are properly diagnosed, the medications they take can prove fatal rather than beneficial.
The National Kidney Foundation encourages people to have kidneys checked in order to protect them when taking medication. For those with kidney damage, knowledge about medications that need to be avoided, replaced or adjusted is vital.
Medicines to Avoid If You Have Chronic Kidney Disease
Pain medications
Prescription pain meds, including non-steroidal anti-inflammatory drugs (NSAIDs), can reduce blood flow to the kidneys. Narcotic pain medications, on the other hand, can build up in the body resulting in serious problems for people with CKD.
Anti-microbial medications
Some antibiotics, antiviral, and anti-fungal medicines are cleared by the kidneys, which is why using them when you have kidney damage can have a negative impact on your health. It is important to use kidney-safe anti-microbial medications.
Diabetes medications
Diabetes is a leading cause of kidney disease but the medications to treat it, including insulin, are cleared by the kidneys. This makes the problem twofold for people with diabetes and chronic kidney disease.
Renin inhibitors
For years, renin inhibitors were known to be effective in managing CKD because of its ability to block renin-angiotensin-aldosterone system (RAAS) that plays a pivotal role in the pathogenesis of CKD progression and the increase of complications that go with it.
But recent studies show that combining angiotensin receptor blockers (ARBs) and ACE inhibitors with aliskiren or blood pressure medicines containing aliskiren can be harmful. In fact, in 2012, the U.S. Food and Drug Administration has issued a warning of the possible risks.
The drug combination should not be used in patients with diabetes as well since it increases the risk of hypertension, renal impairment, and hyperkalemia.
Effects of the Lack of Pharmacological Research and Interventions
Prevention would have been the best way to avoid CKD and the need for dialysis, but due to the lack of pharmacological interventions specifically developed for treating CKD and its associated cardiovascular disease (CVD), patients largely rely on treatments of co-morbidities.
There are also several reasons that therapeutic advances designed to slow down CKD progression have largely failed, including the lack of a profound understanding of the chronic renal damage’s pathophysiology as well as that of its associated CVD.
There is also insufficient understanding as to why some CKD patients progress to ESRD and/or die heart failure and associated CVD.
Among the currently relevant drug targets, only four are on the market while the rest are either in preclinical or Phase I or Phase II of clinical trials.
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