Analgesic-associated nephropathy in the U.S.A.: Epidemiologic, clinical and pathogenetic features

摘要

The original suggestion that an association exists between the ingestion of large amounts of analgesics and the development of interstitial nephropathy was made in 1953 [1]. Since that time, many hundreds of cases illustrating this association have been reported from around the world [2, 3]. Presently, most authors refer to the renal disease which develops in patients who consume large amounts of analgesics as analgesic "abuse" nephropathy. There are, however, in our opinion, a number of disadvantages to the use of the word "abuse" in that designation. The major disadvantage lies in the judgmental nature of the word abuse. This word implies that something about the patients' use of analgesics is consciously inappropriate. There are, however, no data to support this implication. As we will discuss subsequently, it is not proven that only doses of analgesics beyond those prescribed by physicians or needed for relief of pain are associated with the development of renal disease. We, therefore, prefer to refer to this entity as analgesic "associated" nephropathy (AAN); and we will do so throughout this paper.