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Analgesic nephropathy in Hungary: the HANS study.
Authors:István Pintér  János Mátyus  Zoltán Czégány  Judit Harsányi  Marietta Homoki  Miklós Kassai  Eva Kiss  István Kiss  Erzsébet Ladányi  Lajos Locsey  Lajos Major  Mihály Misz  Lajos Nagy  Kálmán Polner  Jeno Rédl  István Solt  Béla Tichy  Marietta T?r?k  Gábor Varga  Gyula Wagner  Imre Wórum  Béla Zsoldos  László Pótó  Katalin Dérczy  István Wittmann  Judit Nagy
Affiliation:Second Department of Medicine and Nephrological Center, Pécs University, Faculty of Medicine, Pacsirta u. 1, H-7624 Pécs, Hungary.
Abstract:
BACKGROUND: The diagnosis of analgesic nephropathy has improved significantly with modern imaging techniques. We reviewed a large portion of the Hungarian dialysis population to obtain additional insight into the problem. METHODS: Twenty-two participating dialysis units enrolled 1400 patients on renal replacement therapy between 1 January 1995 and 1 January 1998. Patients with no known aetiology (n = 284) were interviewed and studied with renal imaging. We assessed the presence of decreased renal mass combined with either bumpy contours, papillary calcification, or both. The subjects studied were interrogated extensively. RESULTS: Our survey suggested analgesic nephropathy in 47 of 1400 patients (3.3%), 3-fold higher than the EDTA database estimate for Hungary. The analgesics most commonly abused were phenacetin-containing mixtures. The driving symptoms were mainly headache and joint pain. Cardiovascular complications were more common than in the rest of the dialysis population, independent of smoking and lipid values (P<0.01). CONCLUSIONS: Phenacetin should be banned. Our study results support the need for longitudinal cohort and case-control studies in Hungary.
Keywords:analgesic nephropathy   Hungary   renal replacement therapy
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