Analgesic Nephropathy and Phenacetin-Induced Transitional
Cell Carcinoma - Analysis of 300 Patients with Long-Term Consumption of
Phenacetin-Containing Drugs

Porpaczy, P.; Schramek, Paul

doi:10.1159/000473263

Cited by 20 publications

(11 citation statements)

References 3 publications

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“…Other analgesic-associated diseases are: peptic ulser disease [ 165,179,180,189,191,228,232,267]. Their epidemiologic importance can only be estimated, but it is probably greater than that of kidney disease.…”

Section: Resultsmentioning

confidence: 99%

Analgesic-associated nephropathy

Schwarz

1987

Klin Wochenschr

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Although the question of whether or not analgesic abuse leads to a certain type of nephropathy has been investigated since 1953, no conclusive answer has been forthcoming. Epidemiologic investigations on the correlation between analgesic abuse and renal function as well as experimental animal studies have given contradictory results concerning the possibility of analgesic-associated kidney damage. However, studies on the correlation between analgesic abuse and papillary necrosis have demonstrated that this lesion coincides in 69% of the cases with an analgesic history. Follow-up studies of patients with analgesic nephropathy have shown that renal function deteriorates in 60% of the patients with continued abuse and that it stabilizes in 80% of the patients after cessation of abuse. Studies on the legislative restriction of phenacetin/acetaminophen, carried out mostly in Scandinavian countries since 1965, show a 50%-90% decline in signs of analgesic nephropathy (papillary necrosis) following a reduction in the sale of these drugs. The prevalence of analgesic abuse may be underestimated, since up to 80% of the abusers tend to deny their analgesic intake. Obviously, only a small percentage of analgesic abusers (approximately 1%) finally develop nephropathy. Even though the results of epidemiologic and experimental studies are contradictory, the results of investigations on papillary necrosis and on legislative prevention as well as of patient follow-ups tend to indicate a correlation between analgesic abuse and a well-defined type of nephropathy.

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Section: Resultsmentioning

confidence: 99%

Analgesic-associated nephropathy

Schwarz

1987

Klin Wochenschr

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“…Chronic abuse of analgesics is now recognised as a cause of renal pelvis and ureteric tumours (Nagel and Hauge, 1963;Nagel et al, 1971 ;Petkovic, 1972Petkovic, , 1975Petkovic, , 1978Bengtsson et al, 1973;Leistenschneider and Ehmann, 1973;Schabert etal., 1973;Leistenschneider et al, 1974;Landmann-Kolbert er al., 1975;Leistenschneider and Nagel, 1977;Gonwa et al, 1980;Mihatsch et al, 1980;Murphy et al, 1980Murphy et al, , 1981Porpaczy and Schramek, 1981;Nocks et al, 1982;Nikolic and Popovic, 1983;Piper et a/., 1985) and Hultengren et al (1965) were the first to draw attention to this relationship. Most reports on analgesic abuse and renal pelvis tumours have come from Sweden, Switzerland, Australia and West Berlin (Hultengren et al, 1965 ;Angervall et al, 1969;Taylor, 1972;Leistenschneider and Ehmann, 1973;Johansson et al, 1974;Landmann-Kolbert et al, 1975;Mihatsch et al, 1980).…”

Section: Discussionmentioning

confidence: 99%

Tumours of the Renal Pelvis and Ureter: Observations in 170 Patients

Steffens

Nagel

1989

Journal of Urology

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A study was made of 170 patients with renal pelvis or ureteric tumours, 160 of whom underwent surgery between 1948 and 198 1. The most important aetiological factor was chronic phenacetin abuse: 2 1.7% of 83 patients with renal pelvis tumours and 11.4% of those with ureteric tumours gave a history of phenacetin abuse. The latency periods ranged from 2 4 to 26 years. This is the first report of a relationship between abuse of analgesics and urothelial tumours from the Federal Republic of Germany.

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“…Other studies, including autopsy studies, revealed a prevalence of TCC as high as 10% with multifocality in 30% and, often, high-stage and high-grade tumors in patients with analgesic nephropathy. 11,12,14,27 The latent period before a urothelial carcinoma develops is 20 years or more and depends on the cumulative dose of analgesics ingested. 4,10-13, 28 Thon and Kliem and their colleagues 15,16 reviewed 2072 renal transplant patients with respect to analgesic nephropathy and TCC.…”

Section: Discussionmentioning

confidence: 99%

“…Transitionalcell carcinoma has been reported to occur more often in patients who abuse analgesics than in nonabusers. 4,[8][9][10][11][12][13][14][15][16][17][18][19] Because TCC may become even more aggressive under immunosuppression, some transplant centers perform routine bilateral nephroureterectomies before or after renal transplantation in analgesic abusers with ESRD to exclude TCC of the upper urinary tract. 15,16,20,21 Minimally invasive techniques such as laparoscopy have been developed in various medical disciplines with the view of achieving the same result as open surgical procedures with the same safety for the patient and less trauma.…”

Section: Introductionmentioning

confidence: 99%