Early-Onset Chronic Renal Failure as a Complication of Acute Intermittent Porphyria

In a retrospective survey of patients who have had a provenattack of acute intermittent porphyria (AIP) in the West ofScotland a highly significant association (p < 0·001)was observed between AIP and the development of early-onsetchronic renal failure. Six patients with AIP and chronic renalfailure arising in early middle-age are described. As no othercause could be attributed to the renal failure three possiblecausal links between these two conditions were considered, namely,enhanced susceptibility to analgesic nephropathy, porphyria-inducedhypertension, and nephrotoxic effects of porphyrins and theirprecursors. We suggest that porphyria-induced hypertension isthe most important factor in causing early-onset chronic renalfailure in acute intermittent porphyria