Can a 32-year-old female kidney donor with acute upper respiratory tract infection (common cold) and fever (hyperthermia) take paracetamol (acetaminophen) for symptom management?

From the Guidelines

A 32-year-old female kidney donor with a fever of 38.5°C due to a common cold can safely take paracetamol (acetaminophen) as it is the preferred choice for managing fever and other symptoms, according to the most recent guidelines 1. The recommended dose is 500-1000 mg every 4-6 hours, not exceeding 4000 mg in 24 hours. Paracetamol is generally considered safe for kidney donors as it is not nephrotoxic at recommended doses and doesn't significantly affect kidney function. For symptom relief, she should also rest adequately, maintain good hydration by drinking plenty of fluids, and consider using saline nasal sprays or steam inhalation for congestion. If she prefers an alternative to paracetamol, ibuprofen could be used short-term at the lowest effective dose (400 mg every 6-8 hours with food), but it carries a slightly higher risk of kidney effects, as suggested by previous studies 1. However, the most recent and highest quality study 1 prioritizes paracetamol over non-steroidal anti-inflammatory drugs (NSAIDs) for patients with symptoms similar to COVID-19, which can be applied to common cold symptoms as well. If her fever persists beyond 3 days, symptoms worsen, or she develops difficulty breathing, she should seek medical attention promptly. Paracetamol works by inhibiting prostaglandin synthesis in the central nervous system, which helps reduce fever and pain without the kidney risks associated with some other pain medications. Key considerations for her care include:

• Avoiding dehydration by drinking fluids regularly, but not exceeding 2 liters per day 1
• Avoiding the use of antipyretics solely for reducing body temperature 1
• Using paracetamol only while symptoms of fever and other symptoms are present 1

From the FDA Drug Label

Warnings ... Ask a doctor before use if you have liver disease Ask a doctor or pharmacist before use if you are taking the blood thinning drug warfarin. Stop use and ask a doctor if symptoms do not improve new symptoms occur pain or fever persists or gets worse redness or swelling is present If pregnant or breastfeeding, ask a health professional before use. Do Not Use ... for more than 3 days for fever unless directed by a doctor

The patient in question is a kidney donor, which may imply a potential underlying condition affecting her liver or kidney function. However, there is no explicit information provided about any pre-existing conditions. Given the information provided in the drug label, paracetamol can be used to treat fever. However, it is recommended to use it for no more than 3 days unless directed by a doctor. It is also recommended to ask a doctor before use if the patient has liver disease. Since the patient is a kidney donor and there is no information about her liver function, it is advisable to consult a doctor before taking paracetamol. No other pain killer is mentioned in the provided drug label. 2

From the Research

Kidney Donor with Acute Common Cold and Fever

• The kidney donor, a 32-year-old female, has contracted an acute common cold and is experiencing a fever of 38.5°C.
• The question arises whether she can take paracetamol to manage her fever or if there are alternative pain killers she can use.

Considerations for Kidney Donors

• According to the study 3, ibuprofen can cause renal impairment, especially in elderly patients and those with coronary artery disease.
• However, the study 3 also found that acetaminophen (paracetamol) was not associated with an increased risk of renal impairment.
• Another study 4 highlights the importance of avoiding non-steroidal anti-inflammatory drugs (NSAIDs) in kidney transplant recipients due to the potential risk of nephrotoxicity.

Recommendations for Pain Management

• Based on the available evidence, paracetamol (acetaminophen) may be a suitable option for managing the kidney donor's fever, as it is not associated with an increased risk of renal impairment 3.
• However, it is essential to consult with a healthcare professional before taking any medication, especially for a kidney donor.
• The studies 5, 6, and 7 do not provide direct evidence for pain management in kidney donors with acute common cold and fever but emphasize the importance of careful consideration and monitoring in patients with kidney transplants or donors with acute kidney injury.