Which means roughly 4 out of 5 people who suffered kidney injury did not take take ibuprofen which is something even more worrisome. How do you prevent kidney injury during extreme exercise if you don't take ibuprofen which to me is real question raised by this article and should be of concern to those who might be undertaking a thru hike and pushing big miles. Ibuprofen may add fuel to fire but how do prevent the fire in the first place?