Analgesic Related renal Injury in Man

Abstract

It was first reported in the 1950′s, that the ingestion of large amounts of some painrelieving drugs, consumed over prolonged periods, was associated with the development of kidney disease and renal failure (13). It also became clear that prolonged abuse of analgesics increased the risk of these patients developing urothelial tumours, particularly in the renal pelvis and the upper ureter. More than 30 years later, analgesic nephropathy still remains a controversial issue; where the causal relationship between abuse of analgesics and renal damage and upper urothelial carcinoma is still a matter of debate (12). The diagnosis of the disease remains difficult because the criteria are not well established, the clinical signs are non-specific and abusers tend to deny their analgesic habituation. The key chronic lesion that develops as a result of analgesic abuse is papillary necrosis, but the precise mechanism that underlies this lesion is still unclear and the factors that relate to the progression of renal degenerative changes and malignancy are also a matter of speculation (1).