6. ACE Inhibitors — Like Captopril (for Hypertension & Heart Failure)
Paradoxically, while ACE inhibitors (e.g., captopril, lisinopril) protect kidneys in diabetic patients, they can temporarily reduce kidney filtration in others—especially if:
You’re dehydrated
Have renal artery stenosis (narrowed kidney arteries)
Are on diuretics
📉 What to watch for: A small, expected rise in creatinine (≤30%) is common—but larger increases warrant evaluation.
7. Biologics & Antimalarials for Autoimmune Disease
Infliximab (Remicade): Used for rheumatoid arthritis, Crohn’s—rarely linked to drug-induced lupus nephritis.
Hydroxychloroquine (Plaquenil): Generally kidney-safe, but long-term high-dose use in lupus patients requires monitoring for rare toxicity.
Chloroquine: Higher risk than hydroxychloroquine; largely replaced.
🩺 Reassurance: Kidney injury with these is uncommon—but baseline and periodic urine tests (for protein) are recommended.
8. NSAIDs — The Unlisted (But Critical) Addition
Though not in the original list, ibuprofen, naproxen, and high-dose aspirin deserve urgent mention:
Ezoic
Cause “analgesic nephropathy” with chronic use
Trigger acute kidney injury in volume-depleted states (e.g., illness, dehydration)
Especially risky in older adults and those with heart/kidney disease
⚠️ Key advice: Avoid daily NSAIDs. Use acetaminophen instead when possible—and never take NSAIDs while dehydrated.
Protecting Your Kidneys: 4 Proactive Steps
Hydrate wisely—especially when ill or on medications.
Never mix meds without checking—even OTC drugs and supplements (e.g., NSAIDs + ACE inhibitors = high risk).
Get tested—a simple blood test (creatinine/eGFR) and urine test (ACR) can detect early changes.
Speak up—ask your doctor: “Could this medication affect my kidneys? How will we monitor it?”
Medications are tools—not villains. Many on this list save lives, manage chronic disease, and restore quality of life. The goal isn’t avoidance—it’s awareness. Your kidneys don’t have pain receptors; they whisper before they fail. By listening early—through informed choices and partnership with your care team—you honor these quiet, vital organs… and the life they help you live.
