Analgesic nephropathy in Hungary: the HANS study.
BACKGROUND
The diagnosis of analgesic nephropathy has improved significantly with modern imaging techniques. We reviewed a large portion of the Hungarian dialysis population to obtain additional insight into the problem.


METHODS
Twenty-two participating dialysis units enrolled 1400 patients on renal replacement therapy between 1 January 1995 and 1 January 1998. Patients with no known aetiology (n = 284) were interviewed and studied with renal imaging. We assessed the presence of decreased renal mass combined with either bumpy contours, papillary calcification, or both. The subjects studied were interrogated extensively.


RESULTS
Our survey suggested analgesic nephropathy in 47 of 1400 patients (3.3%), 3-fold higher than the EDTA database estimate for Hungary. The analgesics most commonly abused were phenacetin-containing mixtures. The driving symptoms were mainly headache and joint pain. Cardiovascular complications were more common than in the rest of the dialysis population, independent of smoking and lipid values (P<0.01).


CONCLUSIONS
Phenacetin should be banned. Our study results support the need for longitudinal cohort and case-control studies in Hungary.
Pintér
István
I
Second Department of Medicine and Nephrological Center, Pécs University, Faculty of Medicine, Pacsirta u. 1, H-7624 Pécs, Hungary.
Mátyus
János
J
Czégány
Zoltán
Z
Harsányi
Judit
J
Homoki
Marietta
M
Kassai
Miklós
M
Kiss
Eva
E
Kiss
István
I
Ladányi
Erzsébet
E
Locsey
Lajos
L
Major
Lajos
L
Misz
Mihály
M
Nagy
Lajos
L
Polner
Kálmán
K
Rédl
Jeno
J
Solt
István
I
Tichy
Béla
B
Török
Marietta
M
Varga
Gábor
G
Wagner
Gyula
G
Wórum
Imre
I
Zsoldos
Béla
B
Pótó
László
L
Dérczy
Katalin
K
Wittmann
István
I
Nagy
Judit
J
D018712:Analgesics, Non-Narcotic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007674:Kidney Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010615:Phenacetin / Q000009:adverse effects*; D006435:Renal Dialysis
D018712:Analgesics, Non-Narcotic; D010615:Phenacetin