Renal Damage and Phenacetin

McCutcheon, A. D.

doi:10.5694/j.1326-5377.1962.tb20541.x

Cited by 23 publications

(4 citation statements)

References 16 publications

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“…Since the first publication by Spuhler and Zollinger (32) there has, however, appeared a vast number of reports, especially from Switzerland, Denmark and Sweden (see references in 6, 13) on the connection between the increased appearance of diffuse interstitial nephritis with papillary necroses and the growing abuse of analgesics. In recent years similar reports have appeared from Britain (5,9,22,26,29), Germany (24,30), Australia (17,19,23), Canada (11,20,21,27) and USA (10,31). As phenacetin was included in nearly all the compound preparations that were abused, whereas other ingredients varied considerably, phenacetin as the common factor was suspected as, or considered to be, the most important cause of the kidney damage.…”

Section: Discussionmentioning

confidence: 77%

Deaths From Renal Failure in Abusers of Phenacetin‐containing Drugs

Nordenfelt¹

1972

Journal of Internal Medicine

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Since Feb. 1961 all phenacetin‐ and paracetamol‐conlaining drugs have in Sweden been subject to prescription and thus less easily obtained. In 1961 a report has been published on the abusers of phenacetin‐containing drugs who had died of uraemia at the Medical department of the Central County Hospital in Jönköping between the years 1954–1960. As a direct continuation the present study has been made of 208 patients, 146 men and 62 women, who died of uraemia in 1960–1970. Among them, 64 men and 22 women were very certainly heavy abusers of phenacetin‐containing analgesics. Although phenacetin had been subject to prescription, the deaths of abusers did not decrease but were even doubled in 1966 (13 patients). In 1968 there was a clear regress and in 1970 there were only 3 deaths. A comparison between the two studies shows no changes in either clinical symptoms or patho‐anatomical alterations of the kidneys. The male predominance (unlike all other investigations) is due to the severe abuse among the male workers at a factory in Huskvarna. On microscopic examination it is verified that the most common findings are contraction with chronic interstitial nephritis, tubular damage, especially in the lower nephrons, and papillary necrosis or necrobiosis. The present study confirms the risk of renal damage and ensuing fatal uraemia from daily, protracted abuse of phenacetin‐containing analgesics. It also appears that, although the drug consumption was interrupted, fatal uraemia could develop seven to eight years later. In this study no support has been obtained for the view that bacterial infection is required for the development of renal damage in abusers of analgesics. The fact that Huskvarna workers are now abusing the powder containing 0.50 g phenazone and 0.10 g caffeine, and that during the last few years the number of deaths from uraemia among them has decreased, supports the opinion that this powder does not lead to kidney damage.

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Section: Discussionmentioning

confidence: 77%

Deaths From Renal Failure in Abusers of Phenacetin‐containing Drugs

Nordenfelt¹

1972

Journal of Internal Medicine

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“…Other authors have attempted to tackle the problem at an earlier stage. The work of Grimlund 66 and Hofvander 81 has been referred to earlier in this context, and their work, together with that of Bengtsson,24 McCutcheon,I11, 112 Brun,31 and Rubenstein,141 will be discussed brießy now.…”

Section: Clinical Picturementioning

confidence: 95%

Phenacetin, through the looking glass

Shelley¹

1967

Clin Pharma and Therapeutics

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World literature on renal damage whieh has been attributed to phenacetin is reviewed and evaluated, together with ineidental effeets of the drug on other organ systems. Renal damage due to single drugs is found to be a rarity, and epidemiologieal, pathologieal, and elinieal data are often inadequate to provide a firm basis for the eoneept of "phenaeetin nephropathy." Partieular note is made of possible toxieity of other eommon eonstituents of analgesie mixtures and the meehanisms of renal damage. Animal experimental data is eollated and eompared, and the inadequaey of mueh experimental work is noted. More work, partieularly in the field of epidemiology, and further investigation of individual variation in metabolizing phenaeetin and other eommonly used analgesies are required. A note on existing legislation with regard to phenaeetin‐eontaining analgesies eoncludes the review.

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“…The association between analgesic intake and renal disease was first reported in Europe by Spuhler and ZolUnger in 1953. In Australia, the analgesic syndrome was recognized in the early 1960's (Jacobs and Morris, 1962;McCutcheon, 1962;Kincaid-Smith, 1963). …”

Section: Introductionmentioning

confidence: 99%