Analgesic nephropathy United States

Detailed information concerning the extent of the problem of analgesic nephropathy is limited, particularly for recent years. National annual data were collected in Australia/New Zealand by the Aushalian and New Zealand Dialysis and Transplant Registry (ANZDATA) [51] and in the United States by the United States Renal Data System (USRDS) [52]. In Eu-... 

NSAIDs block the synthesis of COX products of arachidonic acid, which have a critical role in renal hemodynamics, control of tubular function, and renin release. It is now apparent that two isoforms of COX synthesize prostaglandins. COX-1 is a resident or constitutive form and COX-2 is an inducible form that increases with disorders of inflammation. NSAIDs are nonspecific inhibitors of both COX isoforms. Analgesic nephropathy is a common cause of ESRD in a number of countries, reaching 10% in Switzerland and Australia, but is essentially a preventable condition for which biochemical monitoring has proved useful. The incidence of this disease has decreased over the last decade as awareness has improved and phenacetin was withdrawn from over-the-counter analgesic mixtures. In the United States, 1 in 5 citizens (50 miflion) report that they use an... 

Prevention has depended primarily on pnblic health efforts to restrict the sale of phenacetin and combination analgesics. This has effectively rednced analgesic nephropathy in Anstralia and Europe. However, risk continues with continued availability of OTC combination analgesics containing aspirin, acetaminophen, and caffeine in the United States and thronghont the world. 

In the United States the national prevalence of analgesic nephropathy is not well documented. In the 1980 s, local studies showed incidences, ranging from 1.7 in Philadelphia and 2.8% in Washington D.C. to 10% in Northwest North Carolina [34,56,... 

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