St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Analgesic nephropathy

    Phenacetin nephritis; Nephropathy - analgesic

    Analgesic nephropathy involves damage to one or both kidneys caused by overexposure to mixtures of medications, especially over-the-counter pain remedies (analgesics).

    Causes

    Analgesic nephropathy involves damage within the internal structures of the kidney. It is caused by long-term use of analgesics, especially over-the-counter (OTC) medications that contain phenacetin or acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen.

    About 6 or more pills per day for 3 years increases the risk some for this problem. This frequently occurs as a result of self-medicating, often for some type of chronic pain.

    Analgesic nephropathy occurs in about 4 out of 100,000 people, mostly women over 30. The rate has decreased significantly since phenacetin is no longer widely available in OTC preparations.

    Risk factors include:

    • Use of OTC analgesics containing more than one active ingredient
    • Chronic headaches, painful menstrual periods, backache, or musculoskeletal pain
    • Emotional or behavioral changes
    • History of dependent behaviors including smoking, alcoholism, and excessive use of tranquilizers

    Symptoms

    There may be no symptoms. Symptoms of chronic kidney disease are often present over time and may include:

    • Weakness
    • Fatigue
    • Increased urinary frequency or urgency
    • Blood in the urine
    • Flank pain or back pain
    • Decreased urine output
    • Decreased alertness including drowsiness, confusion, and lethargy
    • Decreased sensation, numbness (especially in the legs)
    • Nausea, vomiting
    • Easy bruising or bleeding
    • Swelling, generalized

    Exams and Tests

    A physical examination may show signs of interstitial nephritis or kidney failure.

    Blood pressure may be high. The doctor may hear abnormal heart or lung sounds when listening to the chest with a stethoscope. There may be signs of premature skin aging. There may be swelling, especially in the lower legs.

    Lab tests may show red or white blood cells in the urine, with or without signs of infection. There may be small amounts of protein in the urine.

    Tests that may be done include:

    • Complete blood count
    • CT scan of the kidney
    • Intravenous pyelogram (IVP)
    • Toxicology screen
    • Urinalysis
    • Kidney ultrasound

    Treatment

    The primary goals of treatment are to prevent further damage and to treat any existing kidney failure. The health care provider may tell you to stop taking all suspect painkillers, particularly OTC medications.

    Signs of kidney failure should be treated as appropriate. This may include diet changes, fluid restriction, dialysis or kidney transplant, or other treatments.

    Counseling, behavioral modification, or similar interventions may help you develop alternative methods of controlling chronic pain.

    • Acute renal failure
    • Chronic renal failure
    • Interstitial nephritis
    • Renal papillary necrosis (tissue death)
    • Urinary tract infections, chronic or recurrent
    • Hypertension
    • Transitional cell carcinoma of the kidney or ureter

    When to Contact a Medical Professional

    Call your health care provider if you have signs of this condition, especially if there has been a history of use of painkillers.

    Call your health care provider if blood or solid material is present in the urine, or if your urine output decreases.

    Outlook (Prognosis)

    The damage to the kidney may be acute and temporary, or chronic and long term.

    Prevention

    Follow the directions of the health care provider when using medications, including OTC medications. Do not exceed the recommended dose of medications without the supervision of the health care provider.

    References

    In: Brenner BM, ed. Brenner: Brenner and Rector's the Kidney. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 30.<.p>

    BACK TO TOP

    • Male urinary system

      illustration

      • Male urinary system

        illustration

      Self Care

        Tests for Analgesic nephropathy

          Review Date: 9/8/2013

          Reviewed By: Charles Silberberg, DO, Private Practice specializing in Nephrology, Affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
          adam.com

          A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


          Back  |  Top
          About Us
          Contact Us
          History
          Mission
          Locations & Directions
          Quality Reports
          Annual Reports
          Honors & Awards
          Community Health Needs
          Assessment

          Newsroom
          Services
          Brain & Spine
          Cancer
          Heart
          Maternity
          Orthopedics
          Pulmonary
          Sleep Medicine
          Urgent Care
          Women's Services
          All Services
          Patients & Visitors
          Locations & Directions
          Find a Physician
          Tour St. Luke's
          Patient & Visitor Information
          Contact Us
          Payment Options
          Financial Assistance
          Send a Card
          Mammogram Appointments
          Health Tools
          My Personal Health
          mystlukes
          Spirit of Women
          Health Information & Tools
          Clinical Trials
          Health Risk Assessments
          Employer Programs -
          Passport to Wellness

          Classes & Events
          Classes & Events
          Spirit of Women
          Donate & Volunteer
          Giving Opportunities
          Volunteer
          Physicians & Employees
          For Physicians
          Remote Access
          Medical Residency Information
          Pharmacy Residency Information
          Physician CPOE Training
          Careers
          Careers
          St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
          Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile