The nephrotoxicity of analgesics

Lf, Prescott

doi:10.1111/j.2042-7158.1966.tb07886.x

Cited by 51 publications

(20 citation statements)

References 51 publications

(13 reference statements)

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“…There is now considerable evidence that prolonged intake of analgesics is associated with a form of renal disease characterized by papillary necrosis (Hultengren, 1958;Lindeneg et al, 1959;Burry et al, 1966;Dawborn et al, 1966;Gault et al, 1968). Phenacetin, though never prescribed alone, has been singled out and blamed for this lesion because it is the common factor in analgesic mixtures (Prescott, 1966;Kincaid-Smith, 1967;Shelley, 1967). The other analgesics often prescribed with phenacetin are aspirin, caffeine, amidopyrine or its analogues, and phenazone.…”

Section: Introductionmentioning

confidence: 99%

Papillary Necrosis in Rats Caused by Aspirin and Aspirin-containing Mixtures

Nanra¹,

Kincaid‐Smith²

1970

BMJ

108

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Nearly half the rats gavage-fed with aspirin and aspirin-containing mixtures developed papillary necrosis in 20 weeks. This incidence is similar to that found in rats on A.P.C. mixtures with high and low concentrations of p-chloracetanilide, an impurity of phenacetin. Aspirin alone produced necrosis in 7 out of 19 rats (36.8%) whereas phenacetin in the same dose had failed to cause any renal damage over six to nine months. If these results also apply to man they suggest that aspirin and not phenacetin may be the major factor in analgesic nephropathy in patients taking A.P.C. mixtures. An augmented clearance of aspirin appeared to afford some protection to the medulla, and it is suggested that this observation may have important clinical and epidemiological applications.

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Section: Introductionmentioning

confidence: 99%

Papillary Necrosis in Rats Caused by Aspirin and Aspirin-containing Mixtures

Nanra¹,

Kincaid‐Smith²

1970

BMJ

108

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“…It was thought that these ani mals were protected against possible damage by a fluid diuresis. In another study, caffeine ingestion was shown to result in interstitial changes in the kidney [12], and caffeine has been shown to potentiate stress-induced changes in mice [ 1,13], Prescott [14,15] has also shown an increase in nucleated cells in the urine following caf feine administration in man.…”

Section: Discussionmentioning

confidence: 99%

Caffeine Potentiates the Nephrotoxicity of Mefenamic Acid on the Rat Renal Papilla

Hewitson²,

Birchall³

et al. 1990

Am J Nephrol

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The effect of caffeine given in combination with mefenamic acid on the renal papilla was studied. Sprague-Dawley rats were divided into four groups and gavage fed either control suspension, mefenamic acid, mefenamic acid and caffeine or caffeine alone for 4 months. Semiquantitative urinalysis was performed at 3 months and showed increased haematuria in the mefenamic acid and caffeine group. There were no significant differences in serum creatinine at sacrifice. Renal histology revealed more advanced papillary necrosis in rats gavage fed mefenamic acid and caffeine compared with all other groups (p < 0.0001). Rats fed mefenamic acid alone showed more damage than control and caffeine-fed groups (p < 0.0001, p < 0.0002, respectively). This suggests that caffeine potentiates the nephrotoxicity of the non-steroidal anti-inflammatory drug, mefenamic acid, on the rat renal papilla. The mechanism of this potentiation by caffeine is yet to be defined.

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“…The effect of salicylates on tubular epithelial cells was especially studied in detail. In an experiment with volunteers, a higher excretion of tubular cells in urine was observed during an experimental treat ment with acetylsalicyclic acid (10,11,17). This increased excretion of tubular epithelial cells was accompanied, in the study of Dnbach and Josch (4), by an increase in the leel of some enzymes in urine as well (lactate dehydrogenase, alkaline phosphatase).…”

mentioning

confidence: 86%

Influence of some Antirheumatic Drugs and Cytostatics on Urinary Enzyme Level

Trnavskỳ¹,

Rovenský²

1976

Pharmacology

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In experiments with rats, the influence of the treatment with sodium salicylate (350 mg/kg), phenylbutazone (100 mg/kg), cyclophosphamide (5 mg/kg), 6-mercaptopurine (25 mg/kg) and D-penicillamine (50 mg/kg), on urinary lactate dehydrogenase, leucine aminopeptidase and alanine aminopeptidase was investigated. All these drugs caused an increase in the enzyme levels in urine. In the case of sodium salicylate, the increase occurred only after the first administration of the drug; phenylbutazone caused a gradual increase of the enzymes. Cytostatic drugs caused an increase in the level of the investigated enzymes in urine with a maximum after 1 week of treatment.

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The nephrotoxicity of analgesics

Cited by 51 publications

References 51 publications

Papillary Necrosis in Rats Caused by Aspirin and Aspirin-containing Mixtures

Papillary Necrosis in Rats Caused by Aspirin and Aspirin-containing Mixtures

Caffeine Potentiates the Nephrotoxicity of Mefenamic Acid on the Rat Renal Papilla

Influence of some Antirheumatic Drugs and Cytostatics on Urinary Enzyme Level

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