Analgesic nephropathy papillary calcifications

Clinical evidence suggestive of analgesic nephropathy includes nocturia, renal insufficiency with severe acidosis, persistent urinary tract infection with colic, hematuria, and hypertension (40,41). Nocturia resulting from failure to concentrate urine is usually the earliest functional defect, but like the other symptoms it is non-specific, rendering the diagnosis of analgesic nephropathy difficult. A CT scan showing bilateral small kidneys with bumpy contours, and papillary calcification is accepted to be of sufficient specificity (38,39). 

Figure 3. Renal imaging criteria of analgesic nephropathy as observed in CT scan without contrast material, including a decreased renal size, bumpy contours, and papillary calcifications.

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