Analgesic nephropathy involves damage to one or both kidneys caused by overexposure to mixtures of medicines, especially over-the-counter pain medicines (analgesics).
Phenacetin nephritis; Nephropathy - analgesic
Analgesic nephropathy involves damage within the internal structures of the kidney. It is caused by long-term use of analgesics (pain medicines), especially over-the-counter (OTC) drugs that contain phenacetin or acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen.
This condition frequently occurs as a result of self-medicating, often for some type of chronic pain.
Risk factors include:
Use of OTC analgesics containing more than one active ingredient
Taking 6 or more pills a day for 3 years
Chronic headaches, painful menstrual periods, backache, or musculoskeletal pain
Emotional or behavioral changes
History of dependent behaviors including smoking, alcohol use, and excessive use of tranquilizers
There may be no symptoms in the beginning. Over time, as the kidneys are injured by the medicine, symptoms of kidney disease will develop and include:
Transitional cell carcinoma of the kidney or ureter
When to Contact a Medical Professional
Call your provider if you have signs of this condition, especially if you have been using painkillers for a long time.
Call your provider if you see blood or solid material in your urine, or if the amount of your urine has decreased.
Follow your provider's instructions when using medicines, including OTC drugs. Do not take more than the recommended dose without asking your provider.
Khan KNM, Hard GC, Alden CL. Kidney. In: Haschek WM, Rousseaux CG, Wallig MA, eds. Haschek and Rousseaux's Handbook of Toxicologic Pathology. 3rd ed. Philadelphia, PA: Elsevier; 2013:chap 47.
Taal MW. Risk factors and chronic kidney disease. In: Taal MW, Chertow GM, Marsden PA, Skorecki K, Yu ASL, Brenner BM, eds. Brenner and Rector's The Kidney. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 21.
Charles Silberberg, DO, private practice specializing in nephrology, affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.