From the Guidelines
NSAIDs are more likely to affect the kidneys than Tylenol (acetaminophen). According to the most recent and highest quality study 1, NSAIDs should be avoided in patients with or at risk for chronic kidney disease (CKD) and cardiovascular disease (CVD). This is because NSAIDs can cause kidney damage, particularly with long-term use or in high doses, by inhibiting prostaglandins, which affects kidney blood flow and function.
- Key points to consider:
- NSAIDs can lead to decreased kidney perfusion, acute kidney injury, or in severe cases, chronic kidney disease
- People with existing kidney problems, heart failure, liver disease, or those who are elderly or dehydrated are at higher risk
- Tylenol, on the other hand, is generally considered safer for the kidneys when taken as directed, but can cause liver damage in high doses
- It's essential to follow dosing guidelines and consult with a healthcare provider for personalized advice, especially if you have kidney concerns
- The study 1 recommends assessing renal function and avoiding NSAIDs in patients with an estimated glomerular filtration rate (eGFR) <30 ml/min per 1.73 m2.
- Another study 1 also suggests that NSAIDs, including cyclooxygenase-2 (COX-2) inhibitors, may be particularly harmful under conditions of preexisting kidney insufficiency or diminished kidney blood flow, and recommends using conventional analgesia, such as acetaminophen, for noninflammatory pain in dialysis patients.
- Overall, while both NSAIDs and Tylenol have potential risks, NSAIDs are more likely to affect the kidneys, and caution should be exercised when using them, especially in patients with preexisting kidney problems or those at risk for CKD and CVD 1.
From the Research
Comparison of NSAIDs and Tylenol Effects on the Kidneys
- Both NSAIDs and Tylenol (Acetaminophen) can affect the kidneys, but the nature and likelihood of these effects differ.
- NSAIDs are more likely to affect the kidneys, particularly in individuals with pre-existing kidney problems or those taking other medications that can impact kidney function 2, 3, 4, 5, 6.
- The use of NSAIDs can lead to:
- Reduced renal blood flow and glomerular filtration rate, potentially resulting in acute renal failure 2, 3.
- Electrolyte imbalances, such as hyperkalemia 2, 6.
- Increased risk of acute tubular necrosis and permanent kidney damage 3.
- Fluid retention and edema, although this is typically reversible upon discontinuation of the NSAID 6.
- Tylenol (Acetaminophen), on the other hand, is not typically associated with the same level of kidney risk as NSAIDs, although high doses or long-term use can still cause kidney damage 4.
- It is essential to note that the risk of kidney problems associated with NSAIDs can be mitigated by careful monitoring and consideration of individual patient factors, such as kidney function and comorbidities 4, 5.