Analgesic nephropathy is a chronic kidney disease caused by taking too many pain medications over time, even low-strength over-the-counter pain relievers. Symptoms include abdominal pain, nausea, and difficulty urinating. Avoiding pain relievers is the only way to prevent further kidney damage. Diagnosis involves evaluating physical symptoms and performing toxicology screens. Treatment involves stopping medication use, adopting a low-sodium and low-fat diet, and in advanced cases, dialysis or kidney transplantation may be necessary.
Analgesic nephropathy is a type of chronic kidney disease that occurs when a person takes too many pain medications over a long period of time. Even low-strength over-the-counter (OTC) pain relievers such as aspirin and ibuprofen can lead to symptoms of analgesic nephropathy if an individual consistently ingests pills every day for several weeks or months. A person may experience a range of mild to severe symptoms, including abdominal pain, nausea, and difficulty urinating. Avoiding pain relievers is the only effective way to prevent further damage to the kidneys and give the organs time to begin healing.
When the kidneys are regularly bombarded with foreign chemicals, they gradually become inflamed. Inflammation leads to swelling, which can interfere with the kidneys’ ability to transport and filter waste material through urine. Over-the-counter nonsteroidal anti-inflammatory drugs, acetaminophen, and caffeine-containing drugs are responsible for most cases of analgesic nephropathy. Drugs containing phenacetin are extremely likely to cause kidney problems, but today, phenacetin is rarely prescribed by doctors due to the risks.
Analgesic nephropathy usually takes months to years to develop, and even advanced cases may not cause noticeable symptoms. Early signs of kidney problems may include decreased urine output, frequent urges to urinate, and pain in the abdomen and lower back. A person may feel fatigued most of the time and bruise very easily. In advanced stages, analgesic nephropathy can cause drowsiness, mental confusion, nausea and vomiting. Permanent kidney damage leading to kidney 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 ultrasound, are used to check for physical abnormalities and measure the severity of kidney damage. If test results are inconclusive, a surgeon may need to extract a small sample of kidney tissue for thorough laboratory tests.
After a diagnosis is made, a team of specialists can determine the best way to treat the problem. Patients are generally advised to stop taking over-the-counter medications immediately and adopt diets low in sodium and fat. If the condition is discovered early, kidney damage can usually be reversed within months. Advanced cases of analgesic nephropathy are unlikely to resolve on their own, and the goal of treatment is to minimize the risk of worsening symptoms and kidney failure. Dialysis and kidney transplantation are only needed if serious complications arise despite conservative treatment efforts.
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