Risks Patients Don’t Reveal

Many nephrologists neglect to ask their patients about overthecounter and herbal meds, which pose

Some of the most common over-the-counter and herbal preparations pose serious risks to the kidney, and it is easy for doctors to forget about them when standard medication questionnaires are provided to patients to fill out, according to a presentation at the National Kidney Foundation’s Spring Clinical Meetings, held here today. 

“I often catch myself not asking about over-the-counter and herbal medication use,” says Johann Herberth, MD, MPH, a nephrologist at the University of Kentucky, who will discuss the renal risks of these medications at the meeting. “It’s definitely a black box.”

However, asking a simple question -- “What herbal or over-the-counter medicines do you take?” – could provide a great deal of information regarding reasons for kidney injury, Herberth notes.

Patients often provide medication lists, but fail to mention over-the-counter or herbal medicines, considering them safe since they don’t need a prescription, Herberth notes. Based on his clinical experience, he recommends that health care providers working in nephrology routinely ask their patients if they are taking these medications.

“The major goal of my presentation is to get health care professionals to recognize that “no prescription needed” or “natural” doesn’t mean “no danger,” he says.

Health care professional working with renal patients are usually aware that non-steroidal anti-inflammatory drugs (NSAIDS) can cause kidney problems. In addition, however, there are many other, popular preparations that are less well known to cause metabolic disturbances and serious kidney-related damage.

These include:

  • over-the-counter pain mixtures, which cause a myriad of complex renal pathologies including acute and chronic renal failure and acid-base disturbances;
  • gastrointestinal motility medicines that can alter electrolyte homeostasis;
  • and cold medicines that can cause kidney stones.

Herbal preparations can be even more dangerous, Herberth notes, since they are not regulated by the U.S. Food and Drug Administration, and many people mistakenly believe that because they are “natural,” they must be safe. Drugs that health care providers should be on the lookout for include ephedra which many patients take for weight loss; St. John’s wort, a popular herbal remedy that can alter drug metabolism; and Noni juice, which contains roughly as much potassium as orange or tomato juice.

“I hope more renal health care providers will ask their patients about these preparations as a result of my presentation,” says Herberth.

Herberth will present on April 4, 2008, 3:30-4:30, during session #668.

The National Kidney Foundation is dedicated to preventing kidney and urinary tract diseases, improving the health and well-being of individuals and families affected by these diseases and increasing the availability of all organs for transplantation.

For more information on kidney disease visit www.kidney.org

Posted under: General Health

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