What Is Analgesic Nephropathy?

Analgesic nephropathy mainly refers to various kidney diseases caused by non-steroidal anti-inflammatory analgesics (N SAIDs) 1,2. The pathogenesis of this disease is not fully elucidated 1. The disease is characterized by renal interstitial lymphocytes And plasma cell infiltration, renal interstitial fibrosis, renal tubular degeneration, atrophy or necrosis, can also cause mild glomerular peripheral fibrosis or glomerular atrophy 3. The glomerulus can be basically normal at the beginning, Occasionally mild hyaline degeneration and focal segmental sclerosis. Advanced glomeruli can be sclerotic changes 1. Due to the effectiveness and relative safety of this class of drugs, some of them have been listed as over-the-counter drugs in western countries 4. At the same time when it is used clinically, the damage caused by it will also increase.

Analgesic kidney disease

Analgesic nephropathy mainly refers to various kidney diseases caused by non-steroidal anti-inflammatory analgesics (N SAIDs) 1,2. The pathogenesis of this disease is not fully elucidated 1. The disease is characterized by renal interstitial lymphocytes And plasma cell infiltration, renal interstitial fibrosis, renal tubular degeneration, atrophy or necrosis, can also cause mild glomerular peripheral fibrosis or glomerular atrophy 3. The glomerulus can be basically normal at the beginning, Occasionally mild hyaline degeneration and focal segmental sclerosis. Advanced glomeruli can be sclerotic changes 1. Due to the effectiveness and relative safety of this class of drugs, some of them have been listed as over-the-counter drugs in western countries 4. At the same time when it is used clinically, the damage caused by it will also increase.

Western Medicine Name

Analgesic kidney disease

English name

analgesic nephropathy

Affiliated Department

Internal Medicine-Nephrology

Disease site

kidney

The main symptoms

pain

Main cause

Non-steroidal anti-inflammatory analgesics

Contagious

Non-contagious

Pain is a symptom that often occurs in a person's life. Analgesics have been widely used in clinical practice. Appropriate application according to the needs of the disease can indeed relieve the body's discomfort and achieve the goal of symptomatic treatment. However, in daily life, some people abuse analgesics. As everyone knows, improper use of analgesics can cause gastrointestinal ulcers, gastric bleeding, thrombocytopenic purpura, and bronchial asthma. What's more, people who regularly use painkillers Appearance of renal papillary necrosis or interstitial nephritis, or even renal failure, is medically known as analgesic nephropathy. The peak age of onset is around 50 years old, and the incidence rate for women is 4 times that of men.

Analgesic nephropathy usually starts very slowly and is often caused by chronic medications such as headache, muscle pain, and joint pain. The patient gradually developed symptoms such as polyuria, nocturia, and frequent thirst, indicating that renal condensing function had decreased. Early onset of sterile pyuria is one of the clinical features of this disease, with an incidence of up to 50%. This is caused by the shedding of degeneration and necrosis of the renal nipples. After renal papillary necrosis, it is easy to be complicated by acute urinary tract infection (such as acute pyelonephritis), and bladder irritation symptoms such as fever, chills, low back pain, urgency, dysuria, and frequent urination may occur, and it may cause sepsis and induce toxic shock. Shedding necrotic renal papillary tissue can also cause renal or ureteral colic and hematuria. Some patients have mildly increased blood pressure or complicated hypertension or acute heart failure. However, patients rarely develop edema up to the late stage. Urine routine sometimes has a small amount of urinary protein, so it often fails to get due attention.

After the diagnosis of pain medication nephropathy, all drugs and non-hormonal anti-inflammatory drugs should be stopped first, and other drugs that damage the kidney should be banned. Patients who have an exact history of urinary tract obstruction can use surgery to remove the renal papilla tissue. However, many patients have become addicted to long-term use of painkillers, and should pay special attention to mental support therapy when withdrawing.

Therefore, we should firmly avoid the abuse of painkillers. When taking analgesics, pay attention to drinking more water to increase urine output, improve the solubility of the drug, and avoid precipitating crystals to damage kidney tissue. For long-term users, regular comprehensive urinary system examinations should be performed. Once nocturia increases, mild anemia, and elevated blood pressure, they should go to the hospital as soon as possible to prevent the occurrence of painkiller nephropathy.