ANALGESIC NEPHROPATHY A COMMON FORM OF RENAL DISEASE IN AUSTRALIA

作者：Priscilla Kincaid‐Smith · 发表于：The Medical Journal of Australia · 年份：1969 · DOI：10.5694/j.1326-5377.1969.tb107943.x · 被引用次数：54 · 研究领域：Poisoning and overdose treatments、Drug-Induced Hepatotoxicity and Protection、Pharmacology and Obesity Treatment

Analgesic nephropathy is a common form of renal disease in Australia. A characteristic form of papillary necrosis is the primary lesion in analgesic nephropathy, which is 50 times as common in Australia as it is in the United States of America. The clinical syndrome is most common in middle-aged females. The clinical symptomatology and presentation is characteristic, and a confident diagnosis can usually be made on clinical grounds. Death from uræmia is very rare if patients are under adequate medical supervision; however, patients do die of uræmia due to papillary necrosis when this is undiagnosed, or when dehydration results from insufficient intake of salt and water. Recovery of renal function is the rule, and may continue for many years and be accompanied by considerable hypertrophy of the kidneys. Recovery occurs only if all analgesics are stopped. The condition of patients who stop taking phenacetin but continue to take aspirin and paracetamol mixtures continues to deteriorate or relapse. In experimental animals, lesions which are identical with those seen in man can be reproduced by feeding various analgesics in doses equivalent to those taken by patients, or slightly higher doses. Our experiments thus far have shown that papillary necrosis develops with aspirin-phenacetin-caffeine, aspirin and paracetamol, aspirin and caffeine, and aspirin alone. No papillary necrosis develops with phenacetin alone. Experiments in animals cannot be directly applied to what happens in ...