KIDS
February 14, 2013

Helping Kids in Pain

Painkillers can sometimes damage children's livers and kidneys. Know the risks and remedies.

When our children are in pain, we want to do everything we can to ease their discomfort and often rely on non-prescription painkillers. The health risks associated with acetaminophen – namely, liver problems – have been known for a while, but now it appears that ibuprofen has its own set of risks, particularly in children and teens.

In young children the kidneys are still developing and may be more susceptible to the adverse effects of toxins.

When researchers looked at the number of instances of acute kidney injury (AKI) at one children’s hospital over an 11-year period they found that of the 1015 patients admitted for acute kidney problems, 27 of these cases (or about 2.7%) were due to the use of non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil®) and naproxen (Aleve®).

About 78% of the patients whose AKI was linked to nonsteroidal anti-inflammatory drugs had used the medications for less than 7 days, and 75% had taken the correct dose of the medication.

Most of the patients with AKI linked to NSAIDs were teens, but it was the children younger than five years old who were more likely to have severe cases that required dialysis. This may be because in younger children the kidneys are still developing and are more susceptible to the adverse effects of toxins. About a third of the patients with acute kidney problems also had evidence of chronic kidney problems, but these were mild rather than severe.

About two-thirds of the patients were found to be dehydrated, and this had been linked to the condition in previous studies. Dehydration could affect the likelihood of AKI by concentrating the drug in the blood. The authors point out that it is possible that some of the patients might have developed AKI anyway, even in the absence of the NSAIDs.

Still, there was a clear link between NSAIDs and kidney problems, and it should be taken seriously. "This study underscores the importance of understanding the natural history of NSAID-associated AKI, including the potential for development of chronic kidney disease," said study author Jason Misurac in a news release. "Providers should continue to provide careful NSAID education to parents and children.”

In addition to the potential health risks, the financial cost of treating AKI is considerable, particularly when long-term kidney problems are the result. When giving any kind of medication to your kids, it is important to pay close attention to the correct dosing — and use the drugs only when absolutely necessary. Make sure your child is drinking plenty of water. Not all cases of AKI can be avoided, but doing what you can to reduce the risk as much as possible is always best for a child’s health and a parent’s peace of mind.

The study was carried out at Indiana University’s Riley Hospital for Children and published in the Journal of Pediatrics.

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