Analgesic nephropathy

Alternative names:

nephropathy - analgesic; phenacetin nephritis

Symptoms:

• weakness
• fatigue
• increased urinary frequency or urgency
• blood in the urine
• flank pain or back pain, renal colic (occasional)
• decreased urine output
• decreased alertness
  • drowsiness
  • confusion, delirium
  • lethargy

• decreased sensation, numbness (especially of extremities)
• nausea, vomiting
• easy bruising or bleeding
• swelling, generalized

Note: There may not be any symptoms.

Signs and tests:

An examination may be unrevealing but may indicate interstitial nephritis or renal failure. The blood pressure may be elevated. There may be signs of fluid overload, including abnormal heart or lung sounds. Premature skin aging may be evident.

• A urine toxicology screen may be positive for salicylate.
• A urinalysis shows blood and white cells.
• A CBC may show anemia, with decreased number of red blood cells.
• A histology (examination) of sediment or tissue passed in the urine may show necrotic (dead) papillary tissue.
• An IVP (intravenous pyelogram) may show papillary necrosis (tissue death) or sloughed papillae in the renal pelvis or ureter.