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Acetaminophen: acute and chronic effects on renal function

R C Blantz1

  • 1University of California, San Diego, School of Medicine, La Jolla 92093, USA.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|July 1, 1996
PubMed
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High doses of acetaminophen (APAP) can cause liver and kidney failure due to toxic metabolites. However, APAP alone does not appear to cause chronic kidney disease or analgesic nephropathy.

Area of Science:

  • Pharmacology
  • Toxicology
  • Nephrology

Background:

  • Acetaminophen (APAP) is metabolized by P450 enzymes in the liver and kidney.
  • Therapeutic doses of APAP are generally safe, but overdose (>2,000 mg/kg) generates reactive metabolites causing cellular dysfunction and organ toxicity.
  • Renal toxicity is influenced by factors like chronic liver disease, gender, and altered P450 enzyme activity.

Purpose of the Study:

  • To evaluate the renal toxicity of acetaminophen (APAP), particularly concerning chronic analgesic nephropathy.
  • To differentiate between acute and chronic effects of APAP on renal function.

Main Methods:

  • Review of existing literature on APAP metabolism and toxicity.
  • Analysis of studies investigating the link between APAP and renal disease, including analgesic nephropathy.

Related Experiment Videos

  • Examination of epidemiological data on APAP use and chronic kidney disease.

    • Main Results:

    • Acute overdose of APAP leads to proximal tubule injury and reduced glomerular filtration rate.
    • Limited evidence suggests chronic APAP administration alone causes chronic renal disease or analgesic nephropathy.
    • Epidemiological studies show no significant correlation between APAP use and chronic renal disease or analgesic nephropathy.

    Conclusions:

    • High doses of APAP can cause acute hepatic and renal failure.
    • There is insufficient evidence to support the claim that APAP alone causes chronic analgesic nephropathy.
    • Chronic renal disease and analgesic nephropathy are unlikely to result from APAP use alone.