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Why do NSAIDs damage the kidneys?
NSAIDs block prostaglandins — signaling molecules that keep the small artery feeding each filter relaxed and open. Block them, that vessel tightens, and pressure inside the filter drops.
In a healthy person with normal blood pressure and hydration, that's usually tolerable. If you're dehydrated, on a diuretic, on an ACE inhibitor or ARB, or already have reduced kidney function, that same drop can tip into acute kidney injury.
Long-term daily use also carries a separate risk of chronic interstitial damage. For most CKD patients, acetaminophen is the safer default — check dose and frequency with your care team.
About the author
Swetha Raju
Columbia M.S. Candidate in Clinical Human Nutrition · AKF Certified Kidney Health Coach · NKF Medical Advisory Committee (MAC) Member · NKF peer mentor · CKD patient advocate · Published chronic disease and nutrition researcher
Swetha Raju is the founder of NephroNourish. As a published researcher and lifelong chronic disease patient, she translates renal nutrition and metabolic science into practical guidance people can actually use.
A note on scope. This article is educational and not individual medical advice. Always discuss changes with your nephrologist, dietitian, or care team.