NSAIDs May Offer Pain Relief At The High Cost Of Kidney Failure

A new study has shown NSAIDs have serious side effects which put users at risk of heart attacks, strokes, and kidney or heart failure. Non-steroidal anti-inflammatory drugs, or NSAIDs, are a group of pain relievers, some available over the counter. Examples of this include ibuprofen, naproxen sodium and ketoprofen. Other examples include Advil, Motrin, Aleve and Celebrex.

The study, led by the University of Alabama at Birmingham, was attempting to determine what NSAIDs do to the immune system after a person has suffered heart injury, specifically how do they cause the disruption. A normal response to heart injury happens in two phases. In the first phase, leukocytes from the spleen enter into the left ventricle of the heart to remove dead heart-muscle cells, creating scar tissue in their wake. The next is the resolution phase which works to dampen the inflammation.

Scientists made four discoveries as to how NSAIDs contribute to damage in an already vulnerable body. The subjects of the experiment were mice which had been given carprofen, an NSAID
before suffering experimental heart attacks.

The scientists were watching three parts of the response; these being cardiac function, leukocyte profiling and the spleen. First, mice which had suffered the heart attack had had an impaired response to the inflammation after the heart attack. These mice had increased leukocytes in the left ventricle, the spleen and the neutrophil cells. These cells were not cleared from the neutrophils and developed into an inflammation which would not go away.

The second discovery showed taking carprofen beforehand actually caused the neutrophils in the spleen to activate early and make them even more inflammatory. It triggers the swarming of neutrophils from the spleen, but also compromised the leukocytes in the left ventricle.

The carprofen also failed to limit the amount of cyclooxygenase-1 and cyclooxygenase-2 enzymes which disrupted lipid regulator production and made the inflammation resolution much worse.

Finally, the carprofen led to an imbalance of inflammatory and reparative cytokines after the heart attacks. The result of this was a longer inflammatory phase in the heart.

Scientist have known about some of the down-sides of NSAIDs for a while. While they are normally safe for occasional use, they can cause problems for those suffering from decreased kidney function or any kind of kidney injury or disease. In the worst cases, they can cause kidneys to shut down.

Aside from kidney disease patients, those with heart disease, high blood pressure or liver disease or patients over 65 or who take diuretic medications should only take NSAIDs under doctor supervision. NSAID are also said to increase blood pressure.

Scientists recommend Tylenol for those who need pain relief who have high blood pressure, heart failure, or kidney problems. They caution high doses of Tylenol can cause damage the liver and
recommend taking the lowest dose possible. Individuals should never take more than 4,000 milligrams (mg) a day, which is the same as twelve 325 mg pills.

Those with kidney problems, should not take more than 200 mg a day and only once every 12 hours to limit risks. If Tylenol does not work, a patient should talk to their doctor about alternative. One which may be recommended is Ultram, though only for a short time.

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