Skip to main content
PMC home page
British Medical Journal logoLink to British Medical Journal
. 1971 Feb 27;1(5747):479–482. doi: 10.1136/bmj.1.5747.479

Analgesic Nephropathy: Clinical Syndrome and Prognosis

R M Murray, D H Lawson, A L Linton
PMCID: PMC1795214  PMID: 5101354

Abstract

Over a five-year period 86 patients presented to a renal unit with a history of prolonged analgesic abuse and no other obvious cause of renal damage. Anaemia and peptic ulceration were common, and neurological states suggestive of chronic analgesic intoxication occurred in 22 patients. Thirty-two patients died during follow-up, but the prognosis was much better in patients who ceased abuse of compound analgesics, and improvement could occur even in advanced renal failure. While 84 patients had taken mixtures containing both aspirin and phenacetin, papillary necrosis was also found in two patients who had abused only aspirin, and when phenacetin was withdrawn from several leading compound analgesics, renal function continued to deteriorate in patients ingesting those preparations.

Full text

PDF
479

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bell D., Kerr D. N., Swinney J., Yeates W. K. Analgesic nephropathy. Clinical course after withdrawal of phenacetin. Br Med J. 1969 Aug 16;3(5667):378–382. doi: 10.1136/bmj.3.5667.378. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. CLAUSEN E. HISTOLOGICAL CHANGES IN RABBIT KIDNEYS INDUCED BY PHENACETIN AND ACETYLSALICYLIC ACID. Lancet. 1964 Jul 18;2(7351):123–124. doi: 10.1016/s0140-6736(64)90129-1. [DOI] [PubMed] [Google Scholar]
  3. Fellner S. K., Tuttle E. P. The clinical syndrome of analgesic abuse. Arch Intern Med. 1969 Sep;124(3):379–382. [PubMed] [Google Scholar]
  4. GREER H. D., 3rd, WARD H. P., CORBIN K. B. CHRONIC SALICYLATE INTOXICATION IN ADULTS. JAMA. 1965 Aug 16;193:555–558. doi: 10.1001/jama.1965.03090070005001. [DOI] [PubMed] [Google Scholar]
  5. Gault M. H., Rudwal T. C., Engles W. D., Dossetor J. B. Syndrome associated with the abuse of analgesics. Ann Intern Med. 1968 Apr;68(4):906–925. doi: 10.7326/0003-4819-68-4-906. [DOI] [PubMed] [Google Scholar]
  6. HARVALD B. RENAL PAPILLARY NECROSIS. A CLINICAL SURVEY OF SIXTY-SIX CASES. Am J Med. 1963 Oct;35:481–486. doi: 10.1016/0002-9343(63)90147-5. [DOI] [PubMed] [Google Scholar]
  7. Kincaid-Smith P. Analgesic nephropathy. Ann Intern Med. 1968 Apr;68(4):949–953. doi: 10.7326/0003-4819-68-4-949. [DOI] [PubMed] [Google Scholar]
  8. Levin N. W. Analgesic nephrotoxicity. J Chronic Dis. 1969 Jan;21(8):527–532. doi: 10.1016/0021-9681(69)90048-4. [DOI] [PubMed] [Google Scholar]
  9. McMillan J. M., Lawson D. H., Paton A. M., Linton A. L. The occurrence and clinical features of analgesic abuse in Western Scotland. Scott Med J. 1968 Nov;13(11):382–387. doi: 10.1177/003693306801301104. [DOI] [PubMed] [Google Scholar]
  10. NORDENFELT O., RINGERTZ N. Phenacetin takers dead with renal failure: 27 men and 3 women. Acta Med Scand. 1961 Oct;170:385–402. doi: 10.1111/j.0954-6820.1961.tb00251.x. [DOI] [PubMed] [Google Scholar]
  11. Nanra R. S., Kincaid-Smith P. Papillary necrosis in rats caused by aspirin and aspirin-containing mixtures. Br Med J. 1970 Sep 5;3(5722):559–561. doi: 10.1136/bmj.3.5722.559. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Prescott L. F. Analgesic abuse and renal disease in North-East Scotland. Lancet. 1966 Nov 26;2(7474):1143–1145. doi: 10.1016/s0140-6736(66)90469-7. [DOI] [PubMed] [Google Scholar]
  13. RAPOPORT A., WHITE L. W., RANKING G. N. Renal damage associated with chronic phenacetin overdosage. Ann Intern Med. 1962 Dec;57:970–980. doi: 10.7326/0003-4819-57-6-970. [DOI] [PubMed] [Google Scholar]
  14. Shelley J. H. Phenacetin, through the looking glass. Clin Pharmacol Ther. 1967 May-Jun;8(3):427–471. doi: 10.1002/cpt196783427. [DOI] [PubMed] [Google Scholar]
  15. YOUNG J. V., HAYDON G. B., GRAY C. P., HECKER S. P., LEE P. R. NEPHROPATHY ASSOCIATED WITH THE USE OF ANALGESIC MEDICATIONS. Ann Intern Med. 1965 Apr;62:727–737. doi: 10.7326/0003-4819-62-4-727. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES