Is Motrin (ibuprofen) safe for a patient with impaired renal function (GFR 158) and creatinine level of 0.28?

From the Guidelines

I would not recommend taking Motrin (ibuprofen) with a creatinine of 0.28 and GFR of 158, as NSAIDs can potentially harm kidney function, especially with unusual kidney function values. Motrin belongs to the nonsteroidal anti-inflammatory drug (NSAID) class, which can reduce blood flow to the kidneys and potentially cause further kidney damage, as noted in the 2014 KDOQI commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD 1. While your GFR appears elevated (normal is typically 90-120), which might suggest good kidney function, and your creatinine is low, these unusual values should be discussed with your healthcare provider before taking any medication that affects the kidneys.

Key Considerations

• NSAIDs like Motrin should be avoided in people with GFR < 30 ml/min/1.73 m2, and prolonged therapy is not recommended in people with GFR < 60 ml/min/1.73 m2, according to the guideline 1.
• The guideline also suggests that NSAIDs should not be used in people taking lithium or RAAS blocking agents, and should be used with caution in people with GFR < 60 ml/min/1.73 m2.
• If you need pain relief, acetaminophen (Tylenol) might be a safer alternative as it has minimal effects on kidney function.

Next Steps

• It's essential to consult with your doctor before taking any medication, as they can evaluate your complete medical history and provide personalized recommendations based on your specific kidney function values.
• Your healthcare provider may recommend alternative pain relief options or adjust the dosage of Motrin based on your individual needs and kidney function.

From the Research

Glomerular Filtration Rate (GFR) and Motrine

• The provided studies do not directly address the use of motrine in relation to a GFR of 0.28 or 158, as the units for GFR are typically measured in milliliters per minute per 1.73 square meters (mL/min/1.73 m^2) 2, 3, 4, 5, 6.
• GFR is a critical measure of kidney function, and its evaluation is essential for assessing the severity of chronic kidney disease (CKD) and guiding treatment decisions 2, 3, 5.
• The estimation of GFR can be performed using various formulas, including the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula and the European Kidney Function Consortium (EKFC) formula, each with its own strengths and limitations 4, 6.
• A GFR of 158 mL/min/1.73 m^2 is considered within the normal range or even higher than average, depending on age and other factors, while a value of 0.28 is not a standard unit of measurement for GFR and may be a misunderstanding or misrepresentation of GFR values 2, 4.

Considerations for CKD and GFR

• Patients with severely decreased GFR are at a higher risk for adverse outcomes, including kidney failure, cardiovascular disease, and death 3, 5.
• The risk factors for these outcomes include traditional cardiovascular risk factors, such as hypertension, diabetes, and smoking, as well as factors specific to CKD, like albuminuria and lower eGFR 3, 5.
• Accurate estimation of GFR is crucial for the management of CKD, and the choice of formula may depend on the population being studied and the specific clinical context 4, 6.

Motrine and Kidney Function

• There is no direct information provided in the studies about motrine or its effects on kidney function or GFR 2, 3, 4, 5, 6.
• Without specific data on motrine and its relationship to GFR or kidney function, it is not possible to provide a definitive answer regarding its safety or efficacy in patients with a GFR of 158 or any other value 2, 3, 4, 5, 6.