title: The radiological diagnosis of analgesic nephropathy.
abstract: A study was made of the radiological findings in 57 patients with a clinical diagnosis of analgesic nephropathy. The ages of the patients ranged from 27 to 72 years, and females predominated over males in the ratio 4-7 to 1. Renal failure varied from mild to very severe and the patients showed the usual high incidence of analgesic-induced gastro-intestinal, haematological and neurological disorders. In 82% of cases, kidneys were of normal size, but there was radiological evidence of reduced renal function in 85%. Thus, a small kidney with good renal function was unlikely to be due to analgesic nephropathy. Medullar necrosis was observed in 65%, and papillary atrophy and papillary necrosis each in 46%. Although usually gradual, acute massive sloughing of necrotic papillae could occur and occasionally led to ureteric obstruction. Papillary cavitation was seen in 39% but fistulae and ring shadows were observed in only 11% and 14% respectively, while renal calcification occurred in 26%. With the use of high dose techniques and retrograde pyelography, it is almost always possible to make a positive radiological diagnosis of analgesic nephropathy, even in patients with markedly reduced renal function.
mesh_terms: D000328:Adult; D000368:Aged; D001241:Aspirin / Q000009:adverse effects*; D001284:Atrophy / Q000139:chemically induced; D002114:Calcinosis / Q000139:chemically induced; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology; D007668:Kidney / Q000000981:diagnostic imaging; D007674:Kidney Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging*; D007679:Kidney Medulla; D008297:Male; D008875:Middle Aged; D010615:Phenacetin / Q000009:adverse effects*; D011859:Radiography; D019966:Substance-Related Disorders; D014508:Urea / Q000097:blood; D014517:Ureteral Obstruction / Q000209:etiology
chemical_list: D014508:Urea; D003404:Creatinine; D010615:Phenacetin; D001241:Aspirin