Parliamentary Panel Seeks Painkillers, Antibiotics Under Kidney-Health Scanner

India’s growing kidney disease burden has prompted a Parliamentary panel to call for tighter checks on the misuse of medicines that can damage the kidneys, particularly painkillers and certain antibiotics.

The Parliamentary Standing Committee on Health and Family Welfare, in its 177th report on the “Prevalence of Chronic Kidney Disease in India – Prevention, Diagnosis, Treatment and Management”, has flagged self-medication and the irrational use of nephrotoxic medicines as preventable risks to kidney health.

The panel led by Rajya Sabha MP Ram Gopal Yadav has expressed concern over “limited public awareness regarding the potential adverse effects of prolonged self-medication and inadequate regulation of inappropriate drug use”, particularly in rural and underserved areas.

It has asked the Union Health Ministry, in consultation with the Central Drugs Standard Control Organisation (CDSCO), to review existing rules and awareness measures relating to the over-the-counter availability and irrational use of medicines that can harm the kidneys.

The concern is significant because many people consider common painkillers to be relatively safe and often take them without consulting a doctor. But repeated or prolonged use can affect kidney function and, in some cases, lead to serious kidney injury.

A 2014 study of self-medication practices in Sahaswan, a rural area in northern India, found that painkillers and non-steroidal anti-inflammatory drugs (NSAIDs) were among the medicines most commonly taken without medical advice. Combinations containing drugs such as diclofenac, ibuprofen and nimesulide were frequently used.

The researchers pointed to nephropathy, or kidney damage, as one of the major risks linked to inappropriate use of painkillers.

The risk can be greater among people who are dehydrated or already have diabetes, high blood pressure or undiagnosed kidney disease. In such cases, medicines that affect blood flow to the kidneys can further reduce kidney function.

Another study in 2020 examined 32 patients from Telangana and Andhra Pradesh who had kidney problems linked to analgesic use. The researchers looked at patients with acute or chronic renal failure, chronic kidney disease and nephropathy associated with painkillers. They also examined patterns of misuse, overuse, self-medication, dosage and duration of treatment.

The problem, however, is not limited to painkillers.

A review published in 2024 described drug-induced kidney disease as an important cause of both acute and chronic kidney problems. Medicines can damage the kidneys in different ways — by directly affecting kidney cells, triggering an immune reaction or altering blood flow to the kidneys.

With the number of medicines and newer therapies increasing, experts have stressed the need for greater caution while prescribing and using such drugs.

Certain antibiotics can also affect kidney function. While antibiotics are essential for treating bacterial infections, taking them unnecessarily or without proper medical advice can expose patients to avoidable side effects. Some antibiotics, particularly certain aminoglycosides, are known to have nephrotoxic effects.

Unnecessary antibiotic use also creates another major public-health problem — antimicrobial resistance, which makes infections increasingly difficult to treat.

The panel has therefore called for effective measures to curb indiscriminate antibiotic use, stressing that a “robust, science-driven and evidence-based policy” is needed.

The recommendations come against the backdrop of India’s rising burden of chronic kidney disease (CKD). The committee has cited a pooled CKD prevalence of about 13.24% and noted that the disease often remains undetected until considerable kidney damage has already occurred.

The panel has recommended kidney-function testing every six months for adults aged 20 years and above. It has also called for annual screening of people at higher risk of kidney disease.

For such people, tests such as estimated glomerular filtration rate (eGFR), which measures how well the kidneys filter blood, and urine albumin or protein testing can help identify kidney problems early.

The committee has also identified prolonged exposure to nephrotoxic medicines, including NSAIDs, as a risk factor that needs greater attention.

Experts say the focus should now shift from treating kidney failure at an advanced stage to preventing avoidable kidney damage.

This would require doctors to prescribe medicines carefully, patients to avoid unnecessary self-medication and health authorities to improve public awareness about the risks of commonly used drugs.

People with diabetes and high blood pressure, in particular, need to be cautious because they are already at greater risk of kidney disease. Regular monitoring can help detect declining kidney function before symptoms become obvious.

The parliamentary panel has also recommended public education campaigns to make people aware of the dangers of indiscriminate use of painkillers and other medicines that may harm the kidneys. It has stressed the need for stronger regulation and rational prescribing practices.

With CKD often progressing silently, protecting kidney health may begin with a simple step — not taking medicines repeatedly on one’s own. A pill that appears harmless may carry serious risks when taken in the wrong dose, for too long or without medical advice.