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Trends of Analgesic Nephropathy in Two High-Endemic Regions with Different Legislation

PAUL MICHIELSEN^* and PAUL DE SCHEPPER

^* Department of Medicine, University of Leuven, Leuven, Belgium.
Department of Pharmacology, University of Leuven, Leuven, Belgium.

Correspondence to Dr. Paul Michielsen, Kuleuven, Acacialaan 54, Herent B-3020, Belgium. Phone: 32-16-228345; Fax: 32-16-290946; E-mail: paul.michielsen{at}med.kuleuven.ac.be

Abstract. Analgesic abuse is related to a specific form of interstitial nephritis, but the exact nature of the causal agent remains controversial and this has resulted in differences in regulation. In Flanders, the free sale of phenacetin was banned, but the consumption of other combined analgesics remained free. In New South Wales, phenacetin was also banned, but 2 yr later the sales of all combined analgesics were also prohibited. This study compared the evolution of end-stage renal disease as a result of analgesic nephropathy (AN) in these two high-endemic regions with different legislation. In both regions, the time trend of the age-specific incidence of end-stage renal disease as a result of AN is similar in the age group 45 to 54 yr. In all age groups combined, the time trend of the percentage of AN among the patients admitted for renal replacement therapy is also similar. This finding does not support the hypothesis that non-phenacetin mixed analgesics play a significant role in the occurrence of AN.

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