Analgesic Nephropathy: Clinical Syndrome and Prognosis

Murray, Robin M.; Lawson, D. H.; Linton, A. L.

doi:10.1136/bmj.1.5747.479

Cited by 61 publications

(12 citation statements)

References 18 publications

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“…Renal function usually deteriorates in patients with continued abuse (Table 6). This is also true for the few known cases with further abuse with only aspirin [82, 203,208] or salicylamide [156,216]. Renal function deteriorates in only 18% of the patients who discontinue analgesic abuse (Table 6).…”

Section: Follow-up Studiesmentioning

confidence: 72%

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: Follow-up Studiesmentioning

confidence: 72%

Analgesic-associated nephropathy

Schwarz

1987

Klin Wochenschr

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“…Patients with Established Analgesic Nephropathy.-As it has been shown that recovery ofrenal function depends on abstinence from analgesics (Bell et al, 1969;Kincaid-Smith, 1970;Nitzsche and Bock, 1970;Murray et al, 1971a), patients were repeatedly advised to stop taking them. In spite of this 31 patients continued their analgesic abuse unabated.…”

Section: Resultsmentioning

confidence: 99%

“…Between 1965 and 1971 83 such patients presented to the renal unit of the Western Infirmary, Glasgow (Murray et al, 1971a(Murray et al, , 1971bMurray, 1972;Murray and Smith, 1972 from Askit Powders and from Beecham's Powders, and the amount of aspirin increased. Apart from one patient who took only aspirin all the remainder were taking preparations which continue to contain phenacetin.…”

Section: Methodsmentioning

confidence: 99%

Analgesic Nephropathy: Removal of Phenacetin from Proprietary Analgesics

Murray¹

1972

BMJ

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“…This suggests a persistent toxicomania with persistent analgesic con sumption in A patients even during hemodialysis treat ment. Similar psychiatric disorders (introversion, neuro sis, and denied continued analgesic ingestion) have been previously described by Murray [4] and Murray et al [5].…”

mentioning

confidence: 78%