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NSAID in CKD — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentNSAID in CKDGPhC CRA

A patient with stage 4 chronic kidney disease asks to buy naproxen for shoulder pain. He has been told to avoid nephrotoxic medicines. What is the most appropriate alternative?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Avoid naproxen and advise safer analgesia or prescriber review

NSAIDs can worsen renal function and increase fluid, blood pressure, and gastrointestinal risks in chronic kidney disease. In stage 4 CKD, over-the-counter NSAID supply is generally unsuitable without specialist advice. Alternative analgesia and review of the underlying pain should be considered.

Reference: BNF; NICE CKS