ANALGESIC NEPHROPATHY IN THE 1990S - AN AUSTRALIAN PERSPECTIVE

An algesic nephropathy or analgesic abuse-associated analgesic nephrop athy (AA-AAN) is a disease of the twentieth century. The emergence of AA-AAN was due to aggressive marketing of analgesics and the susceptib ility of individuals with addictive personalities to analgesic abuse. Analgesic abuse resulted in major morbidity and mortality from renal d isease and renal failure, premature atherogenesis with cardiovascular diseases, and the other aspects of the analgesic syndrome; these condi tions have had heavy demands upon health budgets. Legislative restrict ion of analgesic sales in Australia has resulted in a decline in analg esic abuse and end-stage renal failure from AA-AAN. There have also be en changes in the analgesic syndrome. However, the long-term risks of transitional cell carcinoma of the uroepithelium remain as a legacy of analgesic abuse and AA-AAN. Nonsteroidal anti-inflammatory drug-assoc iated analgesic nephropathy (NSAID-AAN) has emerged as a distinct clin ical syndrome, and may become a significant health problem in view of the widespread use and misuse of NSAIDs.