What medications cause kidney tumors?

October 11, 2025 •

4 min read

Decades ago, a painkiller called phenacetin was conclusively linked to kidney and urinary tract cancers, leading to its ban in the US in 1983. The question of what medications cause kidney tumors is not limited to historical drugs, as research continues to explore associations between long-term use of modern medications and renal cancer risk.

Quick Summary

This article details medications associated with an increased risk of kidney tumors, including the banned analgesic phenacetin and historical contrast agent Thorotrast. It also explores potential links between the chronic use of modern painkillers and antihypertensive drugs and renal cancer, emphasizing long-term, high-dose exposure as a key factor and noting that for many medications, the evidence shows association rather than definitive causation. Lifestyle factors are also reviewed.

Key Points

Phenacetin is banned: The painkiller phenacetin was conclusively linked to kidney and urinary tract cancer, leading to its ban in the U.S. in 1983.
Long-term analgesic risk: Chronic, high-dose use of certain modern analgesics like acetaminophen and non-aspirin NSAIDs is associated with an increased, though small, risk of renal cell carcinoma.
Antihypertensive associations: Various blood pressure medications, including ACE inhibitors and diuretics, have shown an association with kidney cancer risk, but it is unclear whether this is due to the drugs or the underlying hypertension.
Thorotrast is historical: A radioactive contrast agent used in the past, Thorotrast was directly linked to renal pelvic cancers and is no longer used.
Nephrotoxicity vs. cancer: Many drugs, like certain chemotherapy agents, cause general kidney damage (nephrotoxicity), but this is not the same as a direct causal link to tumor formation.
Weighing risks: Patients should discuss long-term medication use with a doctor, as the benefits often outweigh the potential, and often inconclusive, risks for many drugs.

Historical Drugs with Established Links to Kidney Tumors

Phenacetin: A Conclusive and Banned Carcinogen

One of the most well-documented cases of a medication causing kidney tumors involves the analgesic phenacetin. Before its ban in 1983, phenacetin was a common ingredient in many over-the-counter painkiller formulations. Extensive case reports and case-control studies established a clear link between the chronic, high-dose use of phenacetin-containing analgesics and the development of cancer of the renal pelvis and urinary bladder. Following the ban of phenacetin, some regions saw a significant decline in these specific cancer rates, highlighting the drug's potent carcinogenic effect.

Thorotrast: The Radioactive Contrast Agent

Thorotrast (thorium dioxide) was a radioactive contrast agent used for medical imaging in the mid-20th century. When this substance was retained in the kidneys after diagnostic procedures like retrograde pyelography, it emitted alpha radiation that led to high rates of carcinoma of the renal pelvis years later. The long-term retention of this radioactive material caused chronic irritation and fibrosis, creating a high-risk precancerous state. Thorotrast is no longer used in medicine.

Modern Medications and Potential Associations

Chronic Use of Common Painkillers

While occasional or low-dose use of common analgesics is considered safe for the kidneys, some studies suggest a potential link between long-term, high-dose use and an increased risk of kidney cancer.

Acetaminophen (Paracetamol): A meta-analysis and a US case-control study found that long-term, over-the-counter acetaminophen use (e.g., for 10 years or more) was associated with an increased risk of renal cell carcinoma (RCC).
Non-steroidal Anti-inflammatory Drugs (NSAIDs): Similar to acetaminophen, chronic, non-aspirin NSAID use has shown an association with a slightly increased risk of kidney cancer in some large-scale studies.
Aspirin: Unlike other NSAIDs, most meta-analyses and studies have not found a clear link between aspirin use and an increased risk of kidney cancer.

Antihypertensive Medications

Several studies have explored the connection between medications for high blood pressure and kidney cancer, with mixed results and ongoing debate.

Meta-analysis findings: A meta-analysis concluded that the use of various antihypertensive drug classes—including ACE inhibitors, angiotensin II receptor blockers (ARBs), beta-blockers, calcium-channel blockers, and diuretics—was significantly associated with an increased risk of kidney cancer. A linear association was observed with the duration of medication use.
The hypertension-cancer link: A crucial point of contention is whether the drugs or the underlying high blood pressure itself is the primary risk factor for kidney cancer. High blood pressure is a known independent risk factor for renal cancer, making it difficult to isolate the effect of the medication.

Other Drug Classes Causing Nephrotoxicity

While not directly linked to tumor formation, many drugs can cause significant damage to kidney tissue (nephrotoxicity), and chronic damage is a general risk factor for various kidney issues.

Chemotherapy Agents: Certain chemotherapeutic drugs, such as ifosfamide and cisplatin, are known to be nephrotoxic and can cause chronic kidney injury.
Immunosuppressants: Calcineurin inhibitors like cyclosporine and tacrolimus can cause chronic interstitial nephritis, a condition linked to kidney damage.
Certain Antibiotics: Aminoglycosides and some other antibiotics are known nephrotoxins.

Historical vs. Modern Drug Risks: A Comparison


Feature	Phenacetin-Containing Analgesics (e.g., A.P.C.)	Modern Analgesics (e.g., Acetaminophen, Ibuprofen)
Carcinogenic Potential	Direct, established human carcinogen, especially with chronic, high-dose use.	Potential association with increased risk, primarily with chronic, high-dose use (especially acetaminophen).
Primary Tumor Type	Cancer of the renal pelvis and urinary tract.	Renal cell carcinoma (RCC), the most common kidney tumor.
Mechanism of Damage	Caused analgesic abuse nephropathy (chronic interstitial nephritis), leading to kidney failure and cancer.	Can cause chronic interstitial nephritis and tubular cell toxicity with prolonged use.
Regulatory Status	Banned in the United States since 1983 due to cancer risk.	Widely available, with label warnings for long-term use and dosage limits.

Conclusion

The evidence concerning medications and kidney tumors distinguishes between a clear historical causality and modern associations that require careful interpretation. Substances like phenacetin and Thorotrast had definite, harmful effects that led to their removal from the market. For contemporary drugs, particularly common over-the-counter analgesics and certain antihypertensives, the risks appear to be tied to chronic, high-dose exposure. Crucially, confounding factors like the underlying medical condition (e.g., hypertension) are significant and must be considered alongside medication use when assessing risk. While these associations warrant attention, they are one piece of a larger picture that includes major risk factors like smoking, obesity, and genetics. Patients should always discuss the long-term use of any medication with their healthcare provider to weigh potential risks against therapeutic benefits. For more information on kidney health, consult resources from the National Institutes of Health (NIH).

Frequently Asked Questions

Long-term, high-dose use of NSAIDs like ibuprofen has been associated with a slightly increased risk of kidney cancer in some studies, but occasional or low-dose use is considered unlikely to be harmful.

Chronic, high-dose use of over-the-counter acetaminophen for ten or more years has been linked to a higher risk of renal cell carcinoma in some research, but occasional use is not considered a risk factor.

Studies have shown an association between various antihypertensive medications and kidney cancer. However, high blood pressure itself is a major risk factor, and researchers are still working to determine if the medications increase risk independently or if it's the underlying condition.

Phenacetin was an analgesic (painkiller) conclusively proven to cause cancer of the kidney and urinary tract. It was banned in the US in 1983 due to this established link.

Yes, many other drugs can cause kidney damage (nephrotoxicity), including certain chemotherapy agents (e.g., cisplatin), immunosuppressants (e.g., cyclosporine), and some antibiotics.

To reduce risk, avoid chronic high-dose use of analgesics without medical supervision, always follow recommended dosages, stay well-hydrated, and discuss any long-term medication use with your healthcare provider.

No. Many drugs can cause different types of kidney damage or toxicity without causing tumors. A link to tumor formation is a specific, and in most cases, rarer, adverse effect.