Preventing non-steroidal anti-inflammatory drug-associated acute kidney injury in young adults: a medication safety and public health perspective

Acute kidney injury (AKI) following short-term over-the-counter (OTC) non-steroidal anti-inflammatory drug (NSAID) use is an increasingly recognized yet under-recognized complication in otherwise healthy young adults. Young adults frequently self-medicate for headaches, sports injuries, dysmenorrhoea, musculoskeletal pain, and viral illnesses without medical advice. Because patients often present with non-specific symptoms, AKI may initially be mistaken for dehydration or viral illness, delaying withdrawal of the offending agent and worsening renal outcomes. This diagnostic delay may also result in unnecessary investigations before medication induced nephrotoxicity is considered.