When doctors start prescribing, side effects (and kidney risks) begin to add up

Don’t take the ride

Would you like to go for a ride on the prescription drug roller coaster?

No? I don’t blame you — I wouldn’t either. But millions of patients do, whether they really want to or not.

Their doctors prescribe a drug for this and a drug for that, and pretty soon they’re riding the ups and downs of unexpected interactions and side effects…which are then often treated with additional drugs.

Meanwhile, most of those patients are probably unaware that their kidneys may be getting a very dangerous workout.

Lying in wait

A few days ago you received a Code Red from HSI’s Michele Cagan to make sure you know about a new FDA warning for a drug linked with kidney damage that’s sometimes fatal.

The drug, zoledronic acid, has two brand names: Zometa, a cancer treatment, and Reclast, a treatment for osteoporosis.

But here’s the catch: The warning applies to patients who already have underlying moderate-to-severe kidney impairment.

And with that, many patients using Reclast will probably think, “Nope. That’s not me. No kidney problems here.”

Well…maybe — maybe not.

Reclast users on the drug roller coaster probably never suspect the various kidney threats that might be lying in wait.

Let’s say you’re one of the thousands of women, post-menopause, who uses a proton pump inhibitor to treat heartburn.

But PPI drugs (such as Nexium, Prilosec, Prevacid, etc.) increase bone fracture risk. And as a post-menopausal woman, you’re already at increased risk of fracture, so your doctor puts you on Reclast.

But guess what? PPI drugs also increase the risk of an inflammatory kidney disorder called interstitial nephritis. In fact, Medscape reported that PPI drug use is one of the most common causes of acute interstitial nephritis.

But this is just one of the popular drugs that can put the kidneys at risk — and the first incline on this rollercoaster ride.

Let’s say you also take one of the most widely used medications of all time — cholesterol-lowering statin drugs. Last year, a British Medical Journal study showed that some statins increase risk of acute kidney failure.

And the National Kidney Foundation website offers this caution about a drug that’s taken by millions every day: “NSAIDs may cause an increased risk of sudden kidney failure and even progressive kidney damage.”

So if you’re post-menopausal and you have arthritis, high cholesterol, heartburn, and early signs of osteoporosis, your rollercoaster of combined medications could easily put you on track to dialysis — or worse.

Of course, if you’d like to get off this ride, you could eat plenty of unprocessed calcium-rich foods, take daily supplements of calcium and vitamin D, and engage in weight-bearing exercises. These are the safest ways to protect against bone weakness — with no undue stress on the kidneys.

Sources:
“FDA Strengthens Kidney Risk Warning for Reclast” Robert Lowes, Medscape, 9/1/11, medscape.com

“Proton pump inhibitors and acute interstitial nephritis” BMJ, Vol. 341, 9/22/10, bmj.com