The effect of acetaminophen on pig kidneys with a 2-bromoethanamine-induced papillary necrosis

Large White pigs were used to investigate the effects of acetaminophen (paracetamol) on normal kidneys or those with an existing renal papillary necrosis. Pairs of young female animals were treated with either a single iv dose of 50 mg/kg 2-bromoethanamine (BEA), 100 mg/kg/day acetaminophen po for 28 days, or a combination of BEA followed by the acetaminophen treatment. Two pigs served as untreated controls. Kidney length, diameter and parenchymal thickness were measured by ultrasound scans, and glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) assessed by 99mTc-DTPA and 131I-hippuran renography prior to treatment and on day 26. Acetaminophen only caused no renal pathology. Despite the lack of a gross RPN, hyperplasia of the pelvic and ureteric urothelia (with extensive vacuolation) was observed following BEA, but BEA followed by acetaminophen for 28 days did not enhance the lesion. The BEA and BEA-acetaminophen groups (but not acetaminophen only) showed an increased ERPF compared with age-matched controls, but there was no significant difference in the overall GFR between the groups.