Diagnostic criteria of analgesic nephropathy in patients with end-stage renal failure: results of the Belgian study.
Diagnostic criteria of analgesic nephropathy with well-defined sensitivity and specificity are not available. During a 2-year period all new patients (n = 273) starting renal replacement therapy in 13 Belgian dialysis units were investigated aiming to select diagnostic criteria of analgesic nephropathy with acceptable performance. Using several interview techniques, a history of analgesic abuse was found in 31% of the patients. Analgesic abusers presenting a clear non-analgesic-related renal diagnosis were excluded from analysis (n = 25). Comparing the remaining abusers (n = 60) and patients without a history of analgesic abuse (n = 188) it was found that renal imaging investigations (sonography plus tomography), showing a decrease in length combined with bumpy contours of both kidneys, presented a sensitivity of 90% and a specificity of 95%. The additional finding of signs of renal papillary necrosis resulted in an overall sensitivity of 72% and a specificity of 97%, giving a positive predictive value of 92%. Other signs frequently mentioned in the literature (hypertension, anaemia, sterile pyuria, bacteriuria, proteinuria) showed insufficient sensitivity and/or specificity to be of help for diagnosing analgesic nephropathy in end-stage renal failure (ESRF) patients starting renal replacement therapy.
Elseviers
M M
MM
Department of Nephrology, Universitair Ziekenhuis Antwerpen, Belgium.
Bosteels
V
V
Cambier
P
P
De Paepe
M
M
Godon
J P
JP
Lins
R
R
Lornoy
W
W
Matthys
E
E
Moeremans
C
C
Roose
R
R
D000328:Adult; D000368:Aged; D000700:Analgesics / Q000009:adverse effects*; D001530:Belgium / Q000453:epidemiology; D002114:Calcinosis / Q000139:chemically induced; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology
D000700:Analgesics