Obituary to analgesic nephropathy--an autopsy study

Area of Science:

• Nephrology
• Pathology
• Toxicology

Background:

• Analgesic nephropathy, characterized by renal papillary and urothelial capillary sclerosis, was studied previously in 1980.
• The Ad Hoc Committee of the International Study Group on Analgesics and Nephropathy recommended further investigation.

Purpose of the Study:

• To determine the prevalence of classic analgesic nephropathy at autopsy in the early 21st century.
• To compare current findings with historical data from 1980.

Main Methods:

• Analysis of 616 consecutive adult autopsies performed between November 2000 and February 2002.
• Histopathological examination of renal cortex, papilla, ureters, and renal arteries using classical methods.

Main Results:

• No cases of papillary necrosis or analgesic nephropathy were detected macroscopically.
• Histologically, vascular lesions (57.8%) and diabetic glomerulosclerosis (13.1%) were most common.
• Only one case of classic analgesic nephropathy with capillary sclerosis was identified, alongside five cases of papillary necrosis without sclerosis.

Conclusions:

• Autopsy prevalence of analgesic nephropathy in Basle decreased from approximately 3% in 1980 to 0.2% in 2000.
• Urinary tract capillary sclerosis, a key indicator, decreased from 4% to a single case.
• Classic analgesic nephropathy has largely disappeared following phenacetin's removal from the market, despite continued use of paracetamol-containing analgesics.