If you have diabetes or kidney disease, it’s important to be careful about the medicines you take. This video describes how the kidneys work and how certain medicines affect the kidneys. Read the following resource to learn more about keeping your kidneys safe: https://www.niddk.nih.gov/health-information/kidney-disease/keeping-kidneys-safe This video was developed by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). For more information, visit https://www.niddk.nih.gov/ — Transcript: If you have diabetes or kidney disease, it’s important to be careful about the medicines you take. Some medicines may harm your kidneys, especially if you take them when you are sick with the flu or diarrhea. To understand why, it helps to know how the kidneys work. You have two kidneys. Your kidneys act as filters. They remove waste and extra water from your body to make urine. The kidney is not one big filter; each kidney is made up of about 1 million tiny filters. Blood flows into each filter through a small blood vessel and out through a small blood vessel. These blood vessels can expand and narrow to change the amount of pressure inside the filter. The amount of pressure in the filter changes how much blood is filtered. It is important that the pressure be kept in a healthy range. If the blood vessel carrying blood INTO the filter narrows, blood cannot flow into the filter as quickly. This lowers the pressure inside the filter. Too little pressure means that your kidneys won’t filter enough blood. However, if the blood vessel carrying blood OUT of the filter narrows, blood cannot flow out as quickly. This raises the pressure inside the filter. Many people with high blood pressure, diabetes, or kidney disease take special kinds of blood pressure medicines, such as lisinopril and losartan and other medicines that end in “pril” or “sartan.” In addition to lowering blood pressure in your whole body, these medicines affect pressure in your kidneys and in their filters, by opening the blood vessels carrying blood out of the filters. If you have certain kinds of kidney disease, lowering pressure in the filters can protect your kidneys. But, if you get sick from something like the flu or diarrhea, the blood pressure in your body may already be low, which makes the pressure in your kidneys low. If you keep taking your blood pressure medicine, the pressure in your filters can get so low that your kidneys won’t filter normally. Certain pain medicines can also harm your kidneys, especially if you are taking blood pressure medicines. These medicines—called NSAIDs—have many names, including ibuprofen, naproxen, and others If you get sick, NSAIDs may cause the blood vessels carrying blood into the filters of your kidney to narrow, lowering the pressure in the filters. This causes the kidney to filter less blood. If you get sick and are taking blood pressure medicines, taking NSAIDs may cause the pressure in your kidneys to drop so much that filtering nearly stops. If you are taking blood pressure medicines or NSAIDS, especially if you have diabetes or kidney disease you should talk to your doctor, nurse, or pharmacist about how to prevent possible complications. For more information visit www.niddk.nih.gov or call 1-800-860-8747.