Analgesic nephropathy in the 1990s--an Australian perspective

Analgesic nephropathy or analgesic abuse-associated analgesic nephropathy (AA-AAN) is a disease of the twentieth century. The emergence of AA-AAN was due to aggressive marketing of analgesics and the susceptibility of individuals with addictive personalities to analgesic abuse. Analgesic abuse resulted in major morbidity and mortality from renal disease and renal failure, premature atherogenesis with cardiovascular diseases, and the other aspects of the analgesic syndrome; these conditions have had heavy demands upon health budgets. Legislative restriction of analgesic sales in Australia has resulted in a decline in analgesic abuse and end-stage renal failure from AA-AAN. There have also been changes in the analgesic syndrome. However, the long-term risks of transitional cell carcinoma of the uroepithelium remain as a legacy of analgesic abuse and AA-AAN. Nonsteroidal anti-inflammatory drug-associated analgesic nephropathy (NSAID-AAN) has emerged as a distinct clinical syndrome, and may become a significant health problem in view of the widespread use and misuse of NSAIDs.