If too much pain killer is taken what happens to the kidney

If too much pain killer is taken what happens to  the kidney

[Dr Sharma]

Hi there. You are right,  NSAIDs are associated with high incidence of renal adverse drug reactions. The cause is change in renal hemodynamics, mediated by prostaglandins. Prostaglandins cause vasodilation of afferent arterioles which helps maintain glomerular perfusion and glomerular filtration rate, an indicator of renal function. In renal failure when kidney tries to maintain renal perfusion pressure by elevated angiotensin II levels which constricts the afferent arteriole aprt from the efferent one which it normally does. NSAIDs block this prostaglandin mediated effect and cause unopposed constriction of the afferent arteriole and decreased renal perfusion pressure.
The other sequelae of renal failure are salt and water rentention and hypertension.
Risk of renal failure is higher especially with an ACE inhibitor and diuretic.
Other rare affects include interstitial nephritis, nephritic syndrome, acute renal failure and acute tubular necrosis.is
Analgesic nephropathy is a risk if used in combination with paracetamol.
Hope this helps.