J. Wisotzky et al., PANCREATIC ALTERATIONS IN CHRONIC NEPHRITIS WITH AND WITHOUT ABUSE OFANALGESICS, Nieren- und Hochdruckkrankheiten, 25(2), 1996, pp. 82-86
Long-term abuse of analgesics (AA) is a well known cause of chronic in
terstitial nephritic. However, a causal association between AA and dam
age of the pancreas has been described only occasionally. 30 patients
suffering from chronic nephritis (23 from analgesic nephropathy) and w
ith habitual analgesic consumption were investigated for morphological
changes of the pancreas by X-ray examination and by ultrasound. The e
xocrine function was evaluated by measuring the concentration of chymo
trypsin in the frees and by the secretin-pancreozymin(caerulein-)test
(SPT). The results were compared with those obtained for a group of 15
patients suffering from chronic pyelonephritis (n = 4) or glomerulone
phritis (n = 11) without AA and a comparable impairment of kidney func
tion. In addition, the results of the SPT were compared to a group of
female patients with known chronic pancreatitis. In the group with AA
were observed morphological changes of the pancreas in 26.7% (in 16.78
by X-ray examination, in 16.7% by ultrasound and in 6.7% with both me
thods), a lower volume of secretion and a significant lower bicarbonat
concentration in the duodenal aspirat. Statistically significant diff
erences in the enzymatic activity were only detected for amylase. Ther
e was no dependance of the pancreatic exocrine function from either th
e renal function or the amount of analgesic and the time of analgesic
intake. The morphological changes of the pancreas which were found exc
lusively in the group with AA as well as the results of the SPT suppor
t the hypothesis that AA may be an ethiological (co-)factor in the dev
elopment of chronic painless pancreatitis.