A patient with CKD is prescribed NSAIDs. Why is this concerning?

• A. NSAIDs can worsen kidney function and precipitate or worsen AKI; avoid or limit use and consider alternatives
• B. They are safe for CKD
• C. They improve kidney function
• D. They cause hyperkalemia only

Answer: (A)

NSAIDs reduce prostaglandin production, which blunts the kidney’s ability to maintain blood flow and filtration. In CKD, this drop in renal perfusion can precipitate acute kidney injury or worsen existing kidney damage. That nephrotoxic effect is why these drugs should be avoided or limited in CKD, with safer alternatives like acetaminophen or non-drug options used instead. The other statements aren’t accurate because NSAIDs are not safe for CKD, they don’t improve kidney function, and hyperkalemia is not the only concern.