What medications are hard on kidneys?

The kidney's everyday enemy is in most bathroom cabinets: NSAIDs. The National Kidney Foundation names non-steroidal anti-inflammatory drugs, including ibuprofen, naproxen, diclofenac, and high-dose aspirin, as the pain medicines needing caution with kidney disease, because they reduce blood flow to the kidneys, which is fine occasionally in healthy people and harmful with regular use, dehydration, or existing kidney problems. The wider list: some antibiotics, certain blood pressure medicines that need careful handling during vomiting-and-diarrhea illnesses, contrast dye for scans in vulnerable kidneys, and high-dose or long courses of various drugs the kidneys must filter. The patterns that turn a manageable drug into a kidney problem: combining NSAIDs with dehydration, like a flu-plus-ibuprofen week; stacking them with blood pressure medicines that already alter kidney blood flow; and using them daily for chronic pain, which is the scenario the NKF wants reviewed. What to do: if you have any kidney issue, ask before any NSAID, since acetaminophen is often the kidney-friendlier pain option the NKF points to; healthy kidneys tolerate occasional NSAID use, but keep it occasional, hydrated, and shortest-course; and if you take blood pressure or diuretic medicines, ask your prescriber about sick-day rules, because pausing certain drugs during vomiting illnesses protects the kidneys. A creatinine blood test once a year tells you where your kidneys stand.