Speaking of an unfortunate patient I met last week, he came in with a significant decrease in his kidney function, and his kidneys were damaged. Surprisingly, he's not a typical kidney patient! So how did his kidneys get so bad? 🤔
He is taking medication for his blood pressure and some heart disease. He takes Losartan, which is used for his blood pressure, and a diuretic, which increases the amount of urine he produces. So one day he has a severe shoulder pain. Unable to bear the pain, he asks the pharmacy for painkillers. So they give him diclofenac, which belongs to the NSAID group. Anyway, he has been using this painkiller for a long time. 😱
That's the devastation that has occurred! We can learn a good lesson from this incident. You probably now understand how dangerous it is to take medication on your own, especially drugs that are everywhere like diclofenac and aspirin, without any understanding.
This is like grocery shopping, taking whatever medication you want, without thinking about the potential harm it could cause. I'll tell you how dangerous it is to take these medications without thinking about the long-term effects. A good example of this is the "Triple Whammy" effect that I see all the time.
Renal function (eGFR)
Measure kidney function based on creatinine value
The dangers of diclofenac, aspirin and other NSAIDs
Diclofenac is one of the most commonly used NSAIDs (non-steroidal anti-inflammatory drugs) in Sri Lanka. It is used to treat conditions such as arthritis, muscle aches, and pain from injuries . While diclofenac is good for short-term pain relief, taking it regularly can cause serious damage to the kidneys. Taking it with medications like ACE inhibitors ( blood pressure lowering drugs - for example , Captopril, Enalapril ) and diuretics (water pills) can cause serious problems for the kidneys over time, even kidney failure.
Aspirin is another NSAID . It is commonly used as a pain reliever. It is also used to treat heart attacks,Doctors give it in small doses to prevent things like strokes. While it's best to take it in small amounts under medical advice, it's dangerous to take it in excess, or with other medications.
The "Triple Whammy" Risk
The most dangerous drug combinations that many people take without realizing it are ACE inhibitors (blood pressure medications), diuretics (water pills), and NSAIDs (such as diclofenac and aspirin). When these three drugs are taken together, they can cause serious damage to the kidneys. Over time, kidney failure can occur. Here's how it happens:
- ACE inhibitors and ARBs (medicines used to treat high blood pressure and heart disease ) work by reducing the stiffness of blood vessels , which reduces the amount of blood flowing to the kidneys.
- Diuretics (medicines commonly used to treat high blood pressure) reduce the amount of water in the body, which in turn reduces the amount of blood going to the kidneys.
- NSAIDs like diclofenac and aspirin reduce the production of chemicals called prostaglandins, which help blood flow to the kidneys.
When you take all three of these drugs together, it causes a significant reduction in the amount of blood going to your kidneys. It's like a "triple whammy." It means your kidneys can't work properly. Over time, your kidneys can't filter the waste products that build up in your blood , which can cause serious problems.
Why is it dangerous to buy medicine from the pharmacy?
The people in pharmacies know how to prescribe medicine, but they are not doctors. They do not know your full health status to find out what is wrong with you. So if you go and take medicine as you want without going to a doctor, it can cause big problems. Because all these medicines work on different systems in the body, especially the kidneys.
Because it is easy to get medicine in Sri Lanka, many people do not think about the harm that these medicines can cause. Taking things like diclofenac and aspirin for headaches, body aches, etc. can gradually harm the body. The kidneys are the first to suffer from this.
The bitter truth of kidney failure
Kidney failure doesn't happen overnight. It happens gradually, and often there are no major symptoms at first. But when you start feeling tired, your legs start to swell, or the amount of urine you pass changes, the damage may have already been done. At that point, you may need dialysis or a kidney transplant. Many people in Sri Lanka have this problem, but they don't realize it until it's too late.
Remember: Always see a doctor.
Please, consult a doctor before taking diclofenac, aspirin, or any other medication. Taking medication as you please will only provide temporary relief. But it can cause serious damage to your body, especially your kidneys. Let's all be aware of our medications and take responsibility for our health.
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