Greater Risk of NSAID Kidney Damage in Long-Distance Runners

It’s probably not surprising, especially if you read this blog often, but nonsteroidal anti-inflammatory drugs (NSAIDs) are in the news again! This time it’s ibuprofen (e.g., Advil, Motrin, Midol, etc.) and its effect on the kidneys of long-distance runners. Why the focus on an NSAID in this specific group? Because a large majority of this population is known to take NSAIDs before or even during marathons under the belief that they increase their tolerance to pain and minimize swelling during competition. However, a new study suggests they may be giving runners some serious NSAID kidney damage in return.

Study Review: Ibuprofen’s Effect on Long-Distance Runners

The new study was conducted under the hypothesis that the risk of kidney damage in long-distance runners using NSAIDs is no greater than it is in runners taking a placebo. For the purpose of this study, subjects were competing in a 50-mile ultramarathon, which is defined as anything over the standard 26.2-mile marathon. The study was a randomized controlled trial (RCT) with a test (ibuprofen) group and a placebo group, totaling 89 subjects in all. It was also double blind, which means neither the subjects nor investigators knew which group the subjects were in during the study. Ibuprofen subjects took ibuprofen at 400 mg (the equivalent to two standard pills) just before the race began and every four hours until the race ended, while the placebo group were given fake pills. Following the race, kidney functions were measured.

The result? Disproving their hypothesis, researchers found that while 44% of all the runners experienced some degree of kidney injury (which is to be expected in runners at this level due to dehydration), there was an 18% jump in kidney injury in runners taking ibuprofen compared to the placebo subjects. In addition, the ibuprofen kidney injury was more severe.

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Kidney Injury Is Only One of Many Risks Associated with NSAIDs

We may sound like an NSAID broken record, but if you’re paying attention, you know that new studies revealing new things about just how dangerous these drugs are just never end. Let’s review some of those side effects:

• Using NDAIDs may actually make arthritis worse.
• Patients who use NSAIDs experience an increase in sudden-death risks from strokes and heart attacks.
• NSAID use increases the risk of gastrointestinal bleeding and other GI issues, heart attacks and heart disease, and kidney problems according to the American Heart Association.
• Takings NSAIDs appears to disrupt stem cells, new bone formation, as well as healing.
• NSAID use can disrupt healing as NSAIDs lessen inflammation, which is essential to the acute healing process; increases the potential for miscarriage; and carries the risk of death due to GI bleeding.

Additionally, the risks aren’t just in those taking NSAIDs for long periods of time, such as someone with chronic back or knee pain; NSAID use for just one week can increase the risk of a heart attack by a whopping 50%!

With NSAID Kidney Damage, Is There an Alternative for Pain Relief for Long-Distance Runners?

Yes. High-quality supplements such as glucosamine and curcumin have been shown to relieve pain and reduce inflammation, even in patients with arthritis. Clinical trials demonstrate that these supplements can be a great substitute even for a prescription NSAID, such as Celebrex. They can be used long term and they don’t carry the dangerous side effects of NSAIDs.

The upshot? Very few of us are probably long-distance runners, and even fewer still run ultramarathons, but the risks of NSAID kidney damage are real whether you’re running 50 miles at a pop or just taking a slow walk around the block. Add to this the long and constantly growing list of other NSAID risks, and there are many, many reasons to stop taking NSAIDs.

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile