Analgesics — still a nephrological cause for concern?

Abstract

Analgesic nephropathy, in its classic form, slowly fades into history. This is a result of the fenacetin ban, consequently introduced in consecutive countries during the second half of the XX century. Potential nephrotoxicity of other analgesic and anti-inflammatory drugs, including paracetamol, a phenacetin metabolite, remains a matter of studies and debate. Theoretical mechanisms of their nephrotoxicity are well known, and supported by the results of experimental studies. However, the clinical proofs are lacking. The present article describes the genesis and clinical picture of analgesic nephropathy, as well as its contribution to the epidemiology of chronic kidney disease in the XX century and at present. Up to date opinions on the nephrotoxicity of currently utilized analgesic and anti-inflammatory drugs are presented.