Abstract
Of 14 patients with analgesic nephropathy 11 were followed up for 9 to 88 (mean 36) months after withdrawal of analgesics containing phenacetin. Ten of these 11 are still alive and have improving, static, or very slowly declining renal function. Analgesic withdrawal is therefore worth achieving even in the presence of advanced renal failure. Careful prolonged follow-up is required to prevent or detect relapse and to deal with the complications of prolonged renal failure, particularly bone disease and acidosis.
Early diagnosis is life-saving in this condition. Attention is drawn to the diagnostic value of sterile pyuria, but the best screening test for the condition is careful interrogation of all patients with chronic renal disease of unknown aetiology; analgesic intake is rarely denied if asked for specifically.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bulger R. J., Healey L. A., Polinsky P. Renal abnormalities in rheumatoid arthritis. Ann Rheum Dis. 1968 Jul;27(4):339–344. doi: 10.1136/ard.27.4.339. [DOI] [PMC free article] [PubMed] [Google Scholar]
- GILMAN A. ANALGESIC NEPHROTOXICITY; A PHARMACOLOGICAL ANALYSIS. Am J Med. 1964 Feb;36:167–173. doi: 10.1016/0002-9343(64)90080-4. [DOI] [PubMed] [Google Scholar]
- 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]
- 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]
- 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]
- Krikler D. M. Paracetamol and the kidney. Br Med J. 1967 Jun 3;2(5552):615–616. doi: 10.1136/bmj.2.5552.615. [DOI] [PMC free article] [PubMed] [Google Scholar]
- LARSEN K., MOLLER C. E. A renal lesion caused by abuse of phenacetin. Acta Med Scand. 1959 May 20;164(1):53–71. doi: 10.1111/j.0954-6820.1959.tb00164.x. [DOI] [PubMed] [Google Scholar]
- 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]
- 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]