Wednesday, November 30, 2016

Analgesic nephropathy notes

Analgesic nephropathy

Characterized by:
Renal insufficiency
Papillary necrosis

Due to:
Toxic drug levels in inner medulla
Causes chronic tubulointerstitial damage
Results from papillary ischemia due to vasoconstriction of medullary blood vessels (vasa recta)

Caused by:
Phenacetin containing preparations

Polyuria (Due to impaired concentrating ability)
NAGMA (Due to tubular damage)
Hematuria (Due to sloughed necrotic papilla)
Sterile pyuria and WBC casts may also be seen
Ureteric colic, obstruction (Due to sloughed necrotic papilla)

At increased risk of:
Premature aging
Atherosclerotic vascular disease
Urinary tract cancer

That's all!

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