Common Analgesic Agents and Their Roles in Analgesic Nephropathy: A Commentary on the Evidence

• Published in: Korean journal of family medicine Vol. 37; no. 6; pp. 310 - 316
• Main Author: Yaxley, Julian
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Family Medicine 01.11.2016; 대한가정의학회
• Subjects: Review; 가정의학; Analgesics; Nephropathy; Renal Insufficiency
• ISSN: 2005-6443; 2092-6715; 2092-6715
• DOI: 10.4082/kjfm.2016.37.6.310

An association between non-opioid analgesic agents and chronic kidney disease has long been suspected. The presumed development of chronic renal impairment following protracted and excessive use of non-opioid analgesia is known as analgesic nephropathy. Many clinicians accept analgesic nephropathy as a real entity despite the paucity of scientific evidence. This narrative review aims to summarize the literature in the field. The weight of available observational literature suggests that long-term ingestion of paracetamol and combination mixtures of aspirin and paracetamol are likely to contribute to chronic renal impairment. However, there is no convincing data to implicate non-steroidal anti-inflammatory drugs or aspirin monotherapy in the development of analgesic nephropathy. In the absence of high-level evidence, while controversy persists, it may be prudent for physicians to consider all non-narcotic analgesics to be nephrotoxic with long-term use.