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. 1969 Apr 26;2(5651):213–216. doi: 10.1136/bmj.2.5651.213

Renal Function in Analgesic Nephropathy

T W Steele, A Z Györy, K D G Edwards
PMCID: PMC1983120  PMID: 5780428

Abstract

Comprehensive one-day renal function tests in 20 patients with a history of analgesic abuse showed varying degrees of chronic renal failure in all. There was no evidence of a selective defect in proximal tubular function, while a defective concentrating mechanism, usually considered necessary for the diagnosis of analgesic-induced renal damage, could be demonstrated in only 16 patients. A urinary acidification defect associated with a concentrating defect was found in nine cases and was thought to reflect specific collecting duct dysfunction. Urinary ammonium excretion was reduced in 13 subjects, owing to a reduced number of functioning nephrons or inadequate acidification, or both. Low citrate excretion was frequently encountered, and this, as well as defective urinary acidification, may play some part in predisposing patients with analgesic nephropathy to intrarenal calcification and progressive renal failure.

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Selected References

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

  1. BALDWIN D. S., GOMBOS E. A., CHASIS H. URINARY CONCENTRATING MECHANISM IN ESSENTIAL HYPERTENSION. Am J Med. 1965 Jun;38:864–872. doi: 10.1016/0002-9343(65)90005-7. [DOI] [PubMed] [Google Scholar]
  2. BERLYNE G. M. Distal tubular function in chronic hydronephrosis. Q J Med. 1961 Oct;30:339–355. [PubMed] [Google Scholar]
  3. BOYARSKY S., SMITH H. W. Renal concentrating operation at low urine flows. J Urol. 1957 Nov;78(5):511–524. doi: 10.1016/S0022-5347(17)66472-3. [DOI] [PubMed] [Google Scholar]
  4. Black D. A. Renal rete mirabile. Lancet. 1965 Dec 4;2(7423):1141–1151. doi: 10.1016/s0140-6736(65)92558-4. [DOI] [PubMed] [Google Scholar]
  5. Burry A. F. The evolution of analgesic nephropathy. Nephron. 1968;5(3):185–201. doi: 10.1159/000179629. [DOI] [PubMed] [Google Scholar]
  6. HEALY J. K., EDWARDS K. D., WHYTE H. M. SIMPLE TESTS OF RENAL FUNCTION USING CREATININE, PHENOLSULPHONPHTHALEIN, AND PITRESSIN. J Clin Pathol. 1964 Sep;17:557–563. doi: 10.1136/jcp.17.5.557. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Harrow B. R. Renal papillary necrosis: a critique of pathogenesis. J Urol. 1967 Feb;97(2):203–208. doi: 10.1016/S0022-5347(17)63013-1. [DOI] [PubMed] [Google Scholar]
  8. KLEEMAN C. R., HEWITT W. L., GUZE L. B. Pyelonephritis. Medicine (Baltimore) 1960 Feb;39:3–116. [PubMed] [Google Scholar]
  9. Kincaid-Smith P. Pathogenesis of the renal lesion associated with the abuse of analgesics. Lancet. 1967 Apr 22;1(7495):859–862. doi: 10.1016/s0140-6736(67)91425-0. [DOI] [PubMed] [Google Scholar]
  10. Kincaid-Smith P., Saker B. M., McKenzie I. F., Muriden K. D. Lesions in the blood supply of the papilla in experimental analgesic nephropathy. Med J Aust. 1968 Feb 10;1(6):203–206. doi: 10.5694/j.1326-5377.1968.tb28455.x. [DOI] [PubMed] [Google Scholar]
  11. Pearson H. H. Residual renal defects in non-fatal phenacetin nephritis. Med J Aust. 1967 Aug 12;2(7):308–313. doi: 10.5694/j.1326-5377.1967.tb97801.x. [DOI] [PubMed] [Google Scholar]
  12. Sanerkin N. G. Chronic phenacetin nephropathy. (With particular reference to the relationship between renal papillary necrosis and "chronic interstitial nephritis"). Br J Urol. 1966 Aug;38(4):361–370. doi: 10.1111/j.1464-410x.1966.tb09722.x. [DOI] [PubMed] [Google Scholar]
  13. WRONG O., DAVIES H. E. The excretion of acid in renal disease. Q J Med. 1959 Apr;28(110):259–313. [PubMed] [Google Scholar]
  14. ZAK G. A., BRUN C., SMITH H. W. The mechanism of formation of osmotically concentrated urine during the antidiuretic state. J Clin Invest. 1954 Jul;33(7):1064–1074. doi: 10.1172/JCI102974. [DOI] [PMC free article] [PubMed] [Google Scholar]

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