Cannabis—also known as marijuana, weed, or pot—has been used for thousands of years for medicine, rituals, and everyday purposes. Today, as cannabis becomes more widely available, many people living with chronic kidney disease (CKD) are asking important questions:

• Can cannabis help with symptoms?
• Is it safe for the kidneys?
• Could it affect transplant eligibility or medications?

In an article from the National Kidney Foundation, kidney specialist and researcher Dr. Joshua Rein explains what we currently know and what we still don’t.*

Listen to the NKF’s Podcast “Cannabis & Kidney Disease: Is it OK to be High?”

What Is Cannabis?

Cannabis is a plant that contains natural chemicals called cannabinoids, which interact with the body’s nervous system.

The two most well-known cannabinoids are:

• THC (tetrahydrocannabinol): Causes the “high” feeling and may help with pain, nausea, and appetite.
• CBD (cannabidiol): Does not cause a high and may help with pain, anxiety, inflammation, and sleep.

Cannabis strains are often described as:

• Sativa: More energizing or uplifting
• Indica: More calming, often used for sleep
• Hybrid: A mix of both

Cannabis also contains terpenes, natural oils that affect smell and potential effects. For example:

• Limonene may boost mood
• Myrcene may help with sleep
• Pinene may increase alertness

Can Cannabis Help People With Kidney Disease?

Some people with CKD use cannabis to help manage symptoms such as:

• Chronic pain
• Nausea or vomiting
• Loss of appetite
• Trouble sleeping
• Itchy skin (pruritus)
• Restless leg syndrome

Cannabis may be appealing because some traditional pain medications are limited in CKD:

• NSAIDs (like ibuprofen) can harm the kidneys
• Opioids carry risks of dependence and side effects
• Acetaminophen is safer for kidneys but may not control severe pain

“Cannabinoid-based treatments are currently used to treat other conditions,” said Dr. Rein. “There is an FDA-approved drug called dronabinol that uses synthetic THC to help patients with cancer or HIV improve their appetite and reduce nausea.”

Are There Risks to Using Cannabis?

Yes—there may be risks, and the science is still evolving.

In a study led by Dr. Rein, researchers found that people who used cannabis experienced a faster decline in kidney function than those who did not.

• Normally, kidney function declines about 1 eGFR point per year
• Cannabis users in the study lost about 2 eGFR points per year

However, the study had important limitations:

• Only a small number of participants used cannabis
• Many also had other risk factors, like smoking or high blood pressure
• Cannabis products today are much stronger than in older studies

“We can’t say for certain how cannabis affects kidney function,” said Dr. Rein. “The study lacks the power to truly make any kind of definitive conclusion.”

Cannabis and Kidney Transplantation

Cannabis use alone doesn’t usually disqualify someone from getting a kidney transplant.

“If cannabis use interferes with your medications or makes it harder to follow your care plan, you may get disqualified,” said Dr. Rein. “Every center is different, though. Be sure to check in with them before using cannabis.”

Cannabis—especially CBD—can interact with transplant medications such as:

• Tacrolimus
• Cyclosporine

These interactions may change drug levels in the body, increasing the risk of rejection or side effects.

“We’re not saying ‘no’ to cannabis,” said Dr. Rein. “But it’s important to have that discussion with your care team so they can help you use it safely and monitor your medications.”

Safer Ways to Use Cannabis

How cannabis is used matters—especially for people with kidney disease.

“Smoke inhalation is harmful to health,” Dr. Rein said. “No one should be inhaling smoke, regardless of kidney status.”

Alternatives to smoking include:

• Edibles (gummies, baked goods)
• Tinctures (drops under the tongue)
• Topicals (lotions or balms for localized pain)

Important safety tips:

• Start with the lowest dose possible
• Be patient—edibles can take longer to work
• Avoid mixing products or changing doses without guidance

What About CBD?

CBD is widely sold over the counter, but it is not risk-free, especially for CKD patients.

Concerns include:

• Some products contain THC even if labeled “THC-free”
• Labels may be inaccurate
• CBD can change how your body processes medications

To reduce risk:

• Choose products with third-party testing
• Look for USDA organic and GMP-certified brands
• Always tell your kidney doctor if you start, stop, or change CBD use

Talk With Your Healthcare Team

Cannabis may help some people with CKD manage symptoms—but it’s not the right choice for everyone.

Before using cannabis or CBD:

1. Talk with your nephrologist or care team
2. Ask about medication interactions
3. Discuss safer options and monitoring

“We want to support our patients, not punish them,” Dr. Rein said. “It’s always better to have an open conversation than to hide it.”

*National Kidney Foundation (June, 2025). “Cannabis and Kidney Disease–What You Need to Know” kidney.org

The information provided by Responsum Health is for educational purposes only and does not replace professional medical advice. Always talk with your healthcare provider before making changes to your treatment or care. Responsum Health does not endorse specific treatments, providers, or products.