title: Paracetamol and analgesic nephropathy: Are you kidneying me?
abstract: BACKGROUND
  Analgesic nephropathy is a disease resulting from the frequent use of combinations of analgesic medications over many years, leading to significant impairment of renal function. The observation of a large number of cases of renal failure in patients abusing analgesic mixtures containing phenacetin led to the initial recognition of the nephrotoxicity from the use of analgesics. Phenacetin was subsequently exclusively blamed for this disease. However, the role of a single analgesic as a sole cause of analgesic nephropathy was challenged, and a number of researchers have since attempted to determine the extent of involvement of other analgesics including nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and paracetamol.
  
  
  METHODS
  We present the case of an 83-year-old woman with a history of NSAID-induced nephropathy with poor pain control and reluctance to use paracetamol. We attempt to briefly review the evidence of paracetamol being implicated in the development of analgesic-induced nephropathy.
  
  
  CONCLUSIONS
  There is a lack of concrete data regarding causative analgesics, including paracetamol. Patients should therefore not be withheld paracetamol, an effective and commonly recommended agent, for fear of worsening renal function.
authors.affiliation: Faculty of Health, University of Canberra, Canberra, ACT, Australia.
authors.forename: Freya
authors.initials: F
authors.lastname: Waddington
authors.affiliation: Faculty of Health, University of Canberra, Canberra, ACT, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Naunton
authors.affiliation: Faculty of Health, University of Canberra, Canberra, ACT, Australia.
authors.forename: Jackson
authors.initials: J
authors.lastname: Thomas
keywords: kidney; nephropathy; paracetamol; phenacetin