Created page with "__NOTOC__ {{Analgesic nephropathy}} {{CMG}} ==Overview== ==Historical Perspective== {{main|Phenacetin|Analgesic}} Analgesics are a class of medications widely used in th..."
New page
__NOTOC__
{{Analgesic nephropathy}}
{{CMG}}
==Overview==
==Historical Perspective==
{{main|Phenacetin|Analgesic}}
[[Analgesic]]s are a class of medications widely used in the treatment of [[pain]]. They include [[aspirin]] and other [[non-steroidal anti-inflammatory drug]]s (NSAIDs), as well as the antipyretics [[paracetamol]] (known as acetaminophen in the United States) and [[phenacetin]]. Introduced in the late 19th century, phenacetin was once a common component of mixed analgesics in parts of Europe, Australia, and the United States.
{{cite journal |author=McLaughlin JK, Lipworth L, Chow WH, Blot WJ |title=Analgesic use and chronic renal failure: a critical review of the epidemiologic literature |journal=Kidney Int. |volume=54 |issue=3 |pages=679–86 |year=1998 |month=September |pmid=9734593 |doi=10.1046/j.1523-1755.1998.00043.x |url=http://dx.doi.org/10.1046/j.1523-1755.1998.00043.x}}
These combined analgesics contained aspirin or other NSAID with phenacetin, paracetamol, or salicylamide, and caffeine or codeine.
{{cite book |last=de Broe |first=Marc E |editor=Curhan, Gary C (ed.) |title=UpToDate |accessdate=2008-09-30 |year=2008 |location=Waltham, MA |chapter=Analgesic nephropathy}}
In the 1950s, Spühler and Zollinger reported an association between kidney injury and the chronic use of phenacetin.
{{cite journal |author=Spühler O, Zollinger HU |title=Die chronisch-interstitielle Nephritis. |language=German |journal=Z Klin Med |volume=151 |issue=1 |pages=1–50 |year=1953 |pmid=13137299 |doi= |url=}}
They noted that chronic users of phenacetin had an increased risk of developing specific kidney injuries, namely [[renal papillary necrosis]] and [[interstitial nephritis|chronic interstitial nephritis]]. This condition was dubbed analgesic nephropathy and was attributed to phenacetin, although no absolute causative role was demonstrated. With further reports of the increased risk of kidney injury with prolonged and excessive phenacetin use, however, phenacetin was banned in several countries between the 1960s and 1980s.
As the use of phenacetin declined, so too did the prevalence of analgesic nephropathy as a cause of end-stage renal disease. Data from [[Switzerland]], for example, demonstrated a decline in the prevalence of analgesic nephropathy among patients with end-stage renal disease, from 28% in 1981 to 12% in 1990.
{{cite journal |author=Brunner FP, Selwood NH |title=End-stage renal failure due to analgesic nephropathy, its changing pattern and cardiovascular mortality. EDTA-ERA Registry Committee |journal=Nephrol. Dial. Transplant. |volume=9 |issue=10 |pages=1371–6 |year=1994 |pmid=7816247 |doi= |url=http://ndt.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=7816247}}
An autopsy study performed in Switzerland suggested that the prevalence of analgesic nephropathy in the general population has likewise decreased; the prevalence was 3% in 1980 and 0.2% in 2000.
While these data demonstrate that analgesic nephropathy has been all but eliminated in some regions, in other regions the condition persists. Notably, in Belgium, the prevalence of analgesic nephropathy among dialysis patients was 17.9% in 1984 and 15.6% in 1990.
{{cite journal |author=Elseviers MM, de Broe ME |title=Analgesic nephropathy in Belgium is related to the sales of particular analgesic mixtures |journal=Nephrol. Dial. Transplant. |volume=9 |issue=1 |pages=41–6 |year=1994 |pmid=8177475 |doi= |url=http://ndt.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=8177475}}
{{cite journal |author=Noels LM, Elseviers MM, de Broe ME |title=Impact of legislative measures on the sales of analgesics and the subsequent prevalence of analgesic nephropathy: a comparative study in France, Sweden and Belgium |journal=Nephrol. Dial. Transplant. |volume=10 |issue=2 |pages=167–74 |year=1995 |pmid=7753450 |doi= |url=http://ndt.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=7753450}}
Michielsen and de Schepper have suggested that analgesic nephropathy persists among Belgian dialysis patients not due to non-phenacetin analgesics, but because Belgium accepts a higher proportion of elderly patients for dialysis. According to these authors, a greater proportion have analgesic nephropathy because a greater percentage of Belgian dialysis patients have been exposed to long-term use of phenacetin.
{{cite journal |author=Michielsen P, de Schepper P |title=Trends of analgesic nephropathy in two high-endemic regions with different legislation |journal=J. Am. Soc. Nephrol. |volume=12 |issue=3 |pages=550–6 |year=2001 |month=March |pmid=11181803 |doi= |url=http://jasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=11181803}}
==References==
{{reflist|2}}
{{WH}}
{{WS}}
[[Category:Nephrology]]
[[Category:Kidney diseases]]