Analgesic nephropathy diagnostic study of choice: Difference between revisions
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==Overview== | ==Overview== | ||
Renal [[biopsy]] is the diagnostic study of choice, however, since it is an [[Invasive (medical)|invasive]] procedure, [[Computed tomography|CT scan]] without [[Contrast medium|contrast]] of the abdomen is usually preferred. | |||
==Diagnostic Study of Choice== | ==Diagnostic Study of Choice== | ||
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=== Renal Biopsy === | === Renal Biopsy === | ||
* Renal biopsy is the diagnostic study of choice.<ref name="Keen Aeddula 2020 p. ">{{cite | last=Keen | first=MU | last2=Aeddula | first2=NR | title=Analgesic Nephropathy | chapter=article-17511 | publisher=StatPearls Publishing | publication-place=Treasure Island (FL) | year=2020 | pmid=31082145 | url=http://www.ncbi.nlm.nih.gov/books/NBK541101/ | access-date=2020-07-06 | page=}}</ref> | * Renal biopsy is the diagnostic study of choice.<ref name="Keen Aeddula 2020 p.">{{cite | last=Keen | first=MU | last2=Aeddula | first2=NR | title=Analgesic Nephropathy | chapter=article-17511 | publisher=StatPearls Publishing | publication-place=Treasure Island (FL) | year=2020 | pmid=31082145 | url=http://www.ncbi.nlm.nih.gov/books/NBK541101/ | access-date=2020-07-06 | page=}}</ref> | ||
* However, renal biopsy is an invasive procedure and there is risk of complications, therefore CT scan without contrast of the abdomen is usually preferred.<ref name="Keen Aeddula 2020 p. ">{{cite | last=Keen | first=MU | last2=Aeddula | first2=NR | title=Analgesic Nephropathy | chapter=article-17511 | publisher=StatPearls Publishing | publication-place=Treasure Island (FL) | year=2020 | pmid=31082145 | url=http://www.ncbi.nlm.nih.gov/books/NBK541101/ | access-date=2020-07-06 | page=}}</ref><ref name="pmid9459649">{{cite journal |author=de Broe ME, Elseviers MM |title=Analgesic nephropathy |journal=N. Engl. J. Med. |volume=338 |issue=7 |pages=446–52 |year=1998 |month=February |pmid=9459649 |doi= |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=9459649&promo=ONFLNS19}}</ref> | * However, renal biopsy is an invasive procedure and there is risk of complications, therefore CT scan without contrast of the abdomen is usually preferred.<ref name="Keen Aeddula 2020 p.">{{cite | last=Keen | first=MU | last2=Aeddula | first2=NR | title=Analgesic Nephropathy | chapter=article-17511 | publisher=StatPearls Publishing | publication-place=Treasure Island (FL) | year=2020 | pmid=31082145 | url=http://www.ncbi.nlm.nih.gov/books/NBK541101/ | access-date=2020-07-06 | page=}}</ref><ref name="pmid9459649">{{cite journal |author=de Broe ME, Elseviers MM |title=Analgesic nephropathy |journal=N. Engl. J. Med. |volume=338 |issue=7 |pages=446–52 |year=1998 |month=February |pmid=9459649 |doi= |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=9459649&promo=ONFLNS19}}</ref> | ||
* The pathology of classic analgesic nephropathy caused by phenacetin and phenacetin-containing analgesics was caused by capillary sclerosis in the renal medulla due to toxic metabolites of phenacetin which would lead to:<ref name="pmid6641031">{{cite journal| author=Mihatsch MJ, Hofer HO, Gudat F, Knüsli C, Torhorst J, Zollinger HU| title=Capillary sclerosis of the urinary tract and analgesic nephropathy. | journal=Clin Nephrol | year= 1983 | volume= 20 | issue= 6 | pages= 285-301 | pmid=6641031 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6641031 }} </ref><ref name="pmid16891638">{{cite journal| author=Mihatsch MJ, Khanlari B, Brunner FP| title=Obituary to analgesic nephropathy--an autopsy study. | journal=Nephrol Dial Transplant | year= 2006 | volume= 21 | issue= 11 | pages= 3139-45 | pmid=16891638 | doi=10.1093/ndt/gfl390 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16891638 }} </ref> | * The pathology of classic analgesic nephropathy caused by phenacetin and phenacetin-containing analgesics was caused by capillary sclerosis in the renal medulla due to toxic metabolites of phenacetin which would lead to:<ref name="pmid6641031">{{cite journal| author=Mihatsch MJ, Hofer HO, Gudat F, Knüsli C, Torhorst J, Zollinger HU| title=Capillary sclerosis of the urinary tract and analgesic nephropathy. | journal=Clin Nephrol | year= 1983 | volume= 20 | issue= 6 | pages= 285-301 | pmid=6641031 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6641031 }} </ref><ref name="pmid16891638">{{cite journal| author=Mihatsch MJ, Khanlari B, Brunner FP| title=Obituary to analgesic nephropathy--an autopsy study. | journal=Nephrol Dial Transplant | year= 2006 | volume= 21 | issue= 11 | pages= 3139-45 | pmid=16891638 | doi=10.1093/ndt/gfl390 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16891638 }} </ref> | ||
** Papillary necrosis | ** Papillary necrosis | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]
Overview
Renal biopsy is the diagnostic study of choice, however, since it is an invasive procedure, CT scan without contrast of the abdomen is usually preferred.
Diagnostic Study of Choice
Renal Biopsy
- Renal biopsy is the diagnostic study of choice.[1]
- However, renal biopsy is an invasive procedure and there is risk of complications, therefore CT scan without contrast of the abdomen is usually preferred.[1][2]
- The pathology of classic analgesic nephropathy caused by phenacetin and phenacetin-containing analgesics was caused by capillary sclerosis in the renal medulla due to toxic metabolites of phenacetin which would lead to:[3][4]
- Papillary necrosis
- Tubulointerstitial nephropathy
- Cortical atrophy
References
- ↑ 1.0 1.1 Template:Cite
- ↑ de Broe ME, Elseviers MM (1998). "Analgesic nephropathy". N. Engl. J. Med. 338 (7): 446–52. PMID 9459649. Unknown parameter
|month=ignored (help) - ↑ Mihatsch MJ, Hofer HO, Gudat F, Knüsli C, Torhorst J, Zollinger HU (1983). "Capillary sclerosis of the urinary tract and analgesic nephropathy". Clin Nephrol. 20 (6): 285–301. PMID 6641031.
- ↑ Mihatsch MJ, Khanlari B, Brunner FP (2006). "Obituary to analgesic nephropathy--an autopsy study". Nephrol Dial Transplant. 21 (11): 3139–45. doi:10.1093/ndt/gfl390. PMID 16891638.