Generally, ibuprofen tends to be worse for kidneys than Tylenol or other acetaminophen-based medications.
For individuals in good health, NSAIDs like ibuprofen aren’t likely to damage their kidneys unless they take them for a prolonged period or in a large dose. If you have healthy kidneys and you take an NSAID for a prolonged period, you could experience interstitial nephritis, a disorder resulting in reduced kidney function, although this typically reverses if it is caused mainly by medication.
However, if you are already struggling with CKD, NSAIDs can severely damage your kidneys by preventing them from receiving the oxygen they need. If you have CKD, you may still be able to take a low-dosage of an NSAID, particularly to help control your risk for heart attack, with minimal impact on your kidneys. However, each individual’s health is different. If you have reduced kidney function, you should always consult with your physician and nephrologist before pursuing an aspirin regimen or using an NSAID.