The association between the use of analgesics and the subsequent development of renal disease has been studied for more than 25 years. The causal relationship between the two has now been accepted by most students of this problem and the characteristics of the typical patient with analgesic nephropathy are known to most nephrologists and to many other physicians. There remain, however, many unanswered questions concerning this disease. Neither the precise analgesic(s) nor the daily dose or cumulative amount of the analgesic(s) that causes the renal disease is known. The proportion of individuals exposed to any given amount or type of analgesic who eventually develop analgesic nephropathy is also unknown. Of particular concern to physicians in the United States is the fact that the importance of analgesic-induced renal disease in this country is still undetermined. This chapter begins with a review of a number of widely accepted “facts” concerning analgesic nephropathy. This review will be brief, since most readers are already aware of these data and since many recent reviews of this problem exist (Kincaid-Smith 1978; T. Murray and Goldberg 1975b). The second part of this chapter is a more detailed review of available data, which deals with the magnitude of the risk of developing renal disease after the use of analgesics. The final section briefly outlines some preliminary data from an ongoing study of the importance of analgesic nephropathy in the United States.
KeywordsRenal Disease Chronic Renal Disease Renal Tubular Acidosis Epidemiologic Factor Papillary Necrosis
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