Painkillers are not advisable for dengue

NSAIDS, or the common painkillers, are not advisable for dengue patients because they are known to quicken internal bleeding. However, doctors have been prescribing them to relieve joint pain in suspected or confirmed cases of chikungunya. Now, in a worrying trend, these drugs have been found to be counterproductive even in chikungunya patients. Doctors in Safdarjung Hospital, Institute of Liver and Biliary Sciences (ILBS), Max Hospital, Saket, and in other medical institutions narrated to TOI instances of chikungunya patients suffering kidney and liver damage to the extent that they needed dialysis and ICU care, respectively.

“We got at least 50 elderly patients with compromised kidney function after suffering from chikungunya. We observed that taking too many painkillers contributed to complications,” said Dr Anup Kumar, professor and head of the department of urology and renal transplant, Safdarjung Hospital. Dr Dinesh Khullar, chairman, department of nephrology and kidney transplant medicine, Max Saket, too reported around five such cases in his hospital.”We managed most of them with conservative treatment and temporary dialysis,” he said. At BLK Super-Specialty Hospital, Dr Sunil Prakash, who head the nephrology unit, added, “We have one patient with viral illness, not confirmed positive for chikungunya, who is on dialysis because of renal failure.” According to Khullar, chikungunya infection has never been associated directly with renal failure, so this new trend is worrying. “Mutation of the virus could be a factor, but our suggestion is that patients pre-disposed to kidney disease stop taking painkillers and keep a close watch on urine output. Decreased urine output is a sign of kidney malfunction,” he said.

Viral infections are known to cause high fever, dehydration, capillary leak and low blood pressure. “NSAIDS complicate the situation by blocking the glands that regulate blood flow to the kidneys when they need it the most,” explained Max’s nephrology head. Maintaining hydration is important for chikungunya management. But doctors advise patients who are predisposed to kidney diseases to avoid coconut water since it contains potassium that may contribute to organ damage.