title: Analgesic nephropathy in Hungary: the HANS study.
abstract: 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.
authors.affiliation: Second Department of Medicine and Nephrological Center, Pécs University, Faculty of Medicine, Pacsirta u. 1, H-7624 Pécs, Hungary.
authors.forename: István
authors.initials: I
authors.lastname: Pintér
authors.forename: János
authors.initials: J
authors.lastname: Mátyus
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Czégány
authors.forename: Judit
authors.initials: J
authors.lastname: Harsányi
authors.forename: Marietta
authors.initials: M
authors.lastname: Homoki
authors.forename: Miklós
authors.initials: M
authors.lastname: Kassai
authors.forename: Eva
authors.initials: E
authors.lastname: Kiss
authors.forename: István
authors.initials: I
authors.lastname: Kiss
authors.forename: Erzsébet
authors.initials: E
authors.lastname: Ladányi
authors.forename: Lajos
authors.initials: L
authors.lastname: Locsey
authors.forename: Lajos
authors.initials: L
authors.lastname: Major
authors.forename: Mihály
authors.initials: M
authors.lastname: Misz
authors.forename: Lajos
authors.initials: L
authors.lastname: Nagy
authors.forename: Kálmán
authors.initials: K
authors.lastname: Polner
authors.forename: Jeno
authors.initials: J
authors.lastname: Rédl
authors.forename: István
authors.initials: I
authors.lastname: Solt
authors.forename: Béla
authors.initials: B
authors.lastname: Tichy
authors.forename: Marietta
authors.initials: M
authors.lastname: Török
authors.forename: Gábor
authors.initials: G
authors.lastname: Varga
authors.forename: Gyula
authors.initials: G
authors.lastname: Wagner
authors.forename: Imre
authors.initials: I
authors.lastname: Wórum
authors.forename: Béla
authors.initials: B
authors.lastname: Zsoldos
authors.forename: László
authors.initials: L
authors.lastname: Pótó
authors.forename: Katalin
authors.initials: K
authors.lastname: Dérczy
authors.forename: István
authors.initials: I
authors.lastname: Wittmann
authors.forename: Judit
authors.initials: J
authors.lastname: Nagy
mesh_terms: 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
chemical_list: D018712:Analgesics, Non-Narcotic; D010615:Phenacetin