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ANALGESIC NEPHROPATHY: CHANGES IN VARIOUS PARAMETERS OF RENAL FUNCTION FOLLOWING CESSATION OF ANALGESIC ABUSE
Author(s) -
Steele T. W.,
Edwards K. D. G.
Publication year - 1971
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1971.tb87510.x
Subject(s) - analgesic , medicine , renal function , anesthesia
Sixteen patients with analgesic nephropathy were followed up for intervals of 12 to 82 months, with an average of 44 months. The results of repeated renal function tests showed that the maximum urinary concentration after vasopressin administration and urinary ammonium excretion after an acid load improved significantly with the passage of time. The minimum urinary pH after an acid load was abnormal at some stage in two‐thirds of the cases, and recovered in few. Urinary citrate excretion was significantly reduced to one‐quarter of normal, with the exception of a few patients with renal tubular acidification defects whose citrate excretion was within the normal range. Improvement in glomerular filtration rate occurred regularly only in patients with acute‐on‐chronic renal failure, and seemed to depend more on good medical management (control of dehydration, acidosis, salt depletion and infection) than on withdrawal of analgesics. However, improvement in filtration rate in these cases, and in concentrating ability and ammonium excretion in all cases, was accompanied by cessation of analgesic abuse. Although continued gross abuse of analgesics can cause deterioration in renal function, a variety of analgesics in small quantities did not adversely affect recovery in some of these cases.