BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuAnalgesic nephropathyPhenacetin nephritis; Nephropathy - analgesic; Nephropathy - NSAIDAnalgesic nephropathy involves damage to one or both kidneys caused by overexposure to mixtures of medicines, especially over-the-counter pain medicines (analgesics). Causes 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) medicines that contain phenacetin or acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen.This condition frequently occurs as a result of self-medicating, often for some type of chronic pain such as headache or arthritis.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 Symptoms There may be no symptoms in the beginning. Over time, as the kidneys are injured by the medicine, symptoms of kidney disease will develop, including:Kidney diseaseChronic kidney disease is the slow loss of kidney function over time. The main job of the kidneys is to remove wastes and excess water from the body...ImageRead Article Now Book Mark Article Fatigue, weakness Increased urinary frequency or urgency Increased urinary frequency or urgencyFrequent urination means needing to urinate more often than usual. Urgent urination is a sudden, strong need to urinate. This causes a discomfort i...ImageRead Article Now Book Mark Article Blood in the urine Flank pain or back pain Flank painFlank pain is pain in one side of the body between the upper belly area (abdomen) and the back.ImageRead Article Now Book Mark Article Decreased urine output Decreased urine outputDecreased urine output means that you produce less urine than normal. Most adults make at least 500 milliliters of urine in 24 hours (a little over ...ImageRead Article Now Book Mark Article Decreased alertness, including drowsiness, confusion, and lethargy Decreased alertnessDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article Decreased sensation, numbness (especially in the legs) Nausea, vomiting Easy bruising or bleeding Swelling (edema) throughout the body Exams and Tests Your health care provider will examine you and ask about your symptoms. During the exam, your provider may find:Your blood pressure is high. When listening with a stethoscope, your heart and lungs have abnormal sounds. You have swelling, especially in the lower legs. Your skin shows premature aging.Tests that may be done include:Complete blood count Complete blood countA complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...ImageRead Article Now Book Mark Article CT scan of kidney Intravenous pyelogram (IVP) Intravenous pyelogramAn intravenous pyelogram (IVP) is a special x-ray exam of the kidneys, bladder, and ureters (the tubes that carry urine from the kidneys to the bladd...ImageRead Article Now Book Mark Article Toxicology screen Toxicology screenA toxicology screen refers to various tests that determine the type and approximate amount of legal and illegal drugs a person has taken by measuring...ImageRead Article Now Book Mark Article Urinalysis UrinalysisUrinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...ImageRead Article Now Book Mark Article Kidney ultrasound Treatment The primary goals of treatment are to prevent further damage of the kidneys and to treat kidney failure. Your provider may tell you to stop taking all suspect painkillers, particularly OTC medicines.To treat kidney failure, your provider may suggest diet changes and fluid restriction. Eventually, dialysis or a kidney transplant may be needed.DialysisDialysis treats end-stage kidney disease also called kidney failure. It removes waste from your blood when your kidneys can no longer do their job. ...Read Article Now Book Mark Article Kidney transplantA kidney transplant is surgery to place a healthy kidney into a person with kidney failure.ImageRead Article Now Book Mark Article Counseling may help you develop alternative methods of controlling chronic pain. Outlook (Prognosis) The damage to the kidney may be acute and temporary, or chronic and long term. Possible Complications Complications that may result from analgesic nephropathy include:Acute kidney failure Acute kidney failureAcute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...ImageRead Article Now Book Mark Article Chronic kidney failure Chronic kidney failureChronic kidney disease is the slow loss of kidney function over time. The main job of the kidneys is to remove wastes and excess water from the body...ImageRead Article Now Book Mark Article Kidney disorder in which the spaces between the kidney tubules become inflamed (interstitial nephritis) Interstitial nephritisInterstitial nephritis is a kidney disorder in which the spaces between the kidney tubules become swollen (inflamed). This can cause problems with t...ImageRead Article Now Book Mark Article Tissue death in areas where the openings of the collecting ducts enter the kidney and where urine flows into the ureters (renal papillary necrosis) Renal papillary necrosisRenal papillary necrosis is a disorder of the kidneys in which all or part of the renal papillae die. The renal papillae are the areas where the ope...ImageRead Article Now Book Mark Article Urinary tract infections that are ongoing or keep coming back High blood pressure Cancer of the kidney or ureterCancerCancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.Read Article Now Book Mark Article When to Contact a Medical Professional Contact your provider if you have any of the following:Symptoms of analgesic nephropathy, especially if you have been using painkillers for a long time Blood or solid material in your urine Amount of your urine has decreased Prevention Follow your provider's instructions when using medicines, including OTCs. Do not take more than the recommended dose without asking your provider.Open ReferencesReferencesAronson JK. Paracetamol (acetaminophen) and combinations. In: Aronson JK, eds. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:474-493.Parazella MA, Rosner MH. Tubulointerstitial diseases. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 35.Segal MS, Yu X. Herbal and over-the-counter medicines and the kidney. In: Johnson RJ,, Floege J, Tonelli M, eds. Comprehensive Clinical Nephrology. 7th ed. Philadelphia, PA: Elsevier; 2024:chap 79.AllVideoImagesTogMale urinary system - illustration The urinary system is made up of the kidneys, ureters, urethra and bladder.Male urinary systemillustrationMale urinary system - illustration The urinary system is made up of the kidneys, ureters, urethra and bladder.Male urinary systemillustrationRelated Information Chronic(Special Topic)Over-the-counter pain relievers(Special Topic)Incidence(Special Topic)Headache(Symptoms)Alcohol use disorder(Condition)Urinary tract infection - adults(Condition)Cystitis - acute(Condition)Interstitial nephritis(Condition)Kidney stones(Condition)Prerenal azotemia(Condition)Back pain and sciatica - InDepth(In-Depth)Alcohol use disorders - InDepth(In-Depth)Urinary tract infection - InDepth(In-Depth) Review Date: 8/28/2023 Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. 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Analgesic nephropathyPhenacetin nephritis; Nephropathy - analgesic; Nephropathy - NSAIDAnalgesic nephropathy involves damage to one or both kidneys caused by overexposure to mixtures of medicines, especially over-the-counter pain medicines (analgesics). Causes 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) medicines that contain phenacetin or acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen.This condition frequently occurs as a result of self-medicating, often for some type of chronic pain such as headache or arthritis.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 Symptoms There may be no symptoms in the beginning. Over time, as the kidneys are injured by the medicine, symptoms of kidney disease will develop, including:Kidney diseaseChronic kidney disease is the slow loss of kidney function over time. The main job of the kidneys is to remove wastes and excess water from the body...ImageRead Article Now Book Mark Article Fatigue, weakness Increased urinary frequency or urgency Increased urinary frequency or urgencyFrequent urination means needing to urinate more often than usual. Urgent urination is a sudden, strong need to urinate. This causes a discomfort i...ImageRead Article Now Book Mark Article Blood in the urine Flank pain or back pain Flank painFlank pain is pain in one side of the body between the upper belly area (abdomen) and the back.ImageRead Article Now Book Mark Article Decreased urine output Decreased urine outputDecreased urine output means that you produce less urine than normal. Most adults make at least 500 milliliters of urine in 24 hours (a little over ...ImageRead Article Now Book Mark Article Decreased alertness, including drowsiness, confusion, and lethargy Decreased alertnessDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article Decreased sensation, numbness (especially in the legs) Nausea, vomiting Easy bruising or bleeding Swelling (edema) throughout the body Exams and Tests Your health care provider will examine you and ask about your symptoms. During the exam, your provider may find:Your blood pressure is high. When listening with a stethoscope, your heart and lungs have abnormal sounds. You have swelling, especially in the lower legs. Your skin shows premature aging.Tests that may be done include:Complete blood count Complete blood countA complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...ImageRead Article Now Book Mark Article CT scan of kidney Intravenous pyelogram (IVP) Intravenous pyelogramAn intravenous pyelogram (IVP) is a special x-ray exam of the kidneys, bladder, and ureters (the tubes that carry urine from the kidneys to the bladd...ImageRead Article Now Book Mark Article Toxicology screen Toxicology screenA toxicology screen refers to various tests that determine the type and approximate amount of legal and illegal drugs a person has taken by measuring...ImageRead Article Now Book Mark Article Urinalysis UrinalysisUrinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...ImageRead Article Now Book Mark Article Kidney ultrasound Treatment The primary goals of treatment are to prevent further damage of the kidneys and to treat kidney failure. Your provider may tell you to stop taking all suspect painkillers, particularly OTC medicines.To treat kidney failure, your provider may suggest diet changes and fluid restriction. Eventually, dialysis or a kidney transplant may be needed.DialysisDialysis treats end-stage kidney disease also called kidney failure. It removes waste from your blood when your kidneys can no longer do their job. ...Read Article Now Book Mark Article Kidney transplantA kidney transplant is surgery to place a healthy kidney into a person with kidney failure.ImageRead Article Now Book Mark Article Counseling may help you develop alternative methods of controlling chronic pain. Outlook (Prognosis) The damage to the kidney may be acute and temporary, or chronic and long term. Possible Complications Complications that may result from analgesic nephropathy include:Acute kidney failure Acute kidney failureAcute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...ImageRead Article Now Book Mark Article Chronic kidney failure Chronic kidney failureChronic kidney disease is the slow loss of kidney function over time. The main job of the kidneys is to remove wastes and excess water from the body...ImageRead Article Now Book Mark Article Kidney disorder in which the spaces between the kidney tubules become inflamed (interstitial nephritis) Interstitial nephritisInterstitial nephritis is a kidney disorder in which the spaces between the kidney tubules become swollen (inflamed). This can cause problems with t...ImageRead Article Now Book Mark Article Tissue death in areas where the openings of the collecting ducts enter the kidney and where urine flows into the ureters (renal papillary necrosis) Renal papillary necrosisRenal papillary necrosis is a disorder of the kidneys in which all or part of the renal papillae die. The renal papillae are the areas where the ope...ImageRead Article Now Book Mark Article Urinary tract infections that are ongoing or keep coming back High blood pressure Cancer of the kidney or ureterCancerCancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.Read Article Now Book Mark Article When to Contact a Medical Professional Contact your provider if you have any of the following:Symptoms of analgesic nephropathy, especially if you have been using painkillers for a long time Blood or solid material in your urine Amount of your urine has decreased Prevention Follow your provider's instructions when using medicines, including OTCs. Do not take more than the recommended dose without asking your provider.Open ReferencesReferencesAronson JK. Paracetamol (acetaminophen) and combinations. In: Aronson JK, eds. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:474-493.Parazella MA, Rosner MH. Tubulointerstitial diseases. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 35.Segal MS, Yu X. Herbal and over-the-counter medicines and the kidney. In: Johnson RJ,, Floege J, Tonelli M, eds. Comprehensive Clinical Nephrology. 7th ed. Philadelphia, PA: Elsevier; 2024:chap 79.