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Analgesic nephropathy in Hungary: the HANS study.
István Pintér1, János Mátyus, Zoltán Czégány
1Second Department of Medicine and Nephrological Center, Pécs University, Faculty of Medicine, Pacsirta u. 1, H-7624 Pécs, Hungary.
Summary
Analgesic nephropathy, particularly from phenacetin, is more prevalent in Hungarian dialysis patients than previously estimated. This highlights the urgent need to ban phenacetin and conduct further research.
Area of Science:
- Nephrology
- Public Health
Background:
- Modern imaging has improved analgesic nephropathy diagnosis.
- A review of the Hungarian dialysis population provides insight into the condition.
Purpose of the Study:
- To assess the prevalence of analgesic nephropathy in Hungarian dialysis patients.
- To identify commonly abused analgesics and associated symptoms.
Main Methods:
- 22 dialysis units enrolled 1400 patients undergoing renal replacement therapy.
- 284 patients with unknown etiology were interviewed and underwent renal imaging.
- Assessment included decreased renal mass, bumpy contours, and papillary calcification.
Main Results:
- Analgesic nephropathy was suggested in 3.3% of patients, three times higher than database estimates.
- Phenacetin-containing mixtures were the most abused analgesics, linked to headache and joint pain.
- Cardiovascular complications were significantly more frequent in affected patients.
Conclusions:
- Phenacetin use should be banned due to its association with analgesic nephropathy.
- Further longitudinal cohort and case-control studies are recommended in Hungary.