What is Analgesic Nephropathy?

Analgesic nephropathy is a type of chronic kidney disorder that occurs when a person takes too many pain-relieving medications over a long period of time. Even low-strength over-the-counter (OTC) analgesics such as aspirin and ibuprofen can lead to symptoms of analgesic nephropathy if an individual consistently ingests pills daily for several weeks or months. A person may experience a range of mild to severe symptoms, including abdominal pain, nausea, and difficulty urinating. Avoiding analgesics is the only effective means of preventing further kidney damage and giving the organs time to start healing.

When the kidneys are bombarded with foreign chemicals on a regular basis, they gradually become inflamed. Inflammation leads to swelling, which can interfere with the kidneys' ability to transport and filter waste material through the urine. OTC nonsteroidal anti-inflammatory drugs, acetaminophen, and caffeine-laced medications are responsible for most cases of analgesic nephropathy. Drugs containing phenacetin are extremely likely to cause kidney problems, but phenacetin is rarely prescribed by doctors today because of the risks.

Analgesic nephropathy usually takes months or years to develop, and even progressed cases may not cause noticeable symptoms. The first signs of kidney trouble may include decreased urine output, frequent urges to urinate, and pains in the abdomen and lower back. A person may feel fatigued most of the time and bruise very easily. In late stages, analgesic nephropathy can cause drowsiness, mental confusion, nausea, and vomiting. Permanent kidney damage leading to renal failure is likely if symptoms are not recognized and treated right away.

A doctor can diagnose analgesic nephropathy by asking about medication use, evaluating physical symptoms, and performing toxicology screens on blood and urine samples. Imaging tests, such as ultrasounds, are used to check for physical abnormalities and gauge the severity of kidney damage. If test results are inconclusive, a surgeon may need to extract a tiny sample of kidney tissue for thorough laboratory testing.

After making a diagnosis, a team of specialists can determine the best way to treat the problem. Patients are typically advised to stop taking OTC medications immediately and adopt low-sodium, low-fat diets. If the condition is discovered early, kidney damage can usually be reversed in a few months. Progressed cases of analgesic nephropathy are unlikely to go away on their own, and the goal of treatment is to minimize the risk of worsening symptoms and renal failure. Dialysis and kidney transplant are only needed if serious complications arise despite conservative treatment efforts.