Aspirin and Analgesic Nephropathy

MacKlon, A. F.; Craft, A. W.; Thompson, M.; Kerr, David

doi:10.1136/bmj.1.5908.597

Cited by 52 publications

(4 citation statements)

References 35 publications

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“…Mixtures containing both paracetamol and aspirin are associated with greater renal toxicity than either agent used alone 3536). This was confirmed in a Belgian prospective controlled study of 400 primary care patients followed for seven years between 1984–1992 37).…”

Section: Aspirinmentioning

confidence: 76%

Common Analgesic Agents and Their Roles in Analgesic Nephropathy: A Commentary on the Evidence

Yaxley

2016

Korean J Fam Med

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An association between non-opioid analgesic agents and chronic kidney disease has long been suspected. The presumed development of chronic renal impairment following protracted and excessive use of non-opioid analgesia is known as analgesic nephropathy. Many clinicians accept analgesic nephropathy as a real entity despite the paucity of scientific evidence. This narrative review aims to summarize the literature in the field. The weight of available observational literature suggests that long-term ingestion of paracetamol and combination mixtures of aspirin and paracetamol are likely to contribute to chronic renal impairment. However, there is no convincing data to implicate non-steroidal anti-inflammatory drugs or aspirin monotherapy in the development of analgesic nephropathy. In the absence of high-level evidence, while controversy persists, it may be prudent for physicians to consider all non-narcotic analgesics to be nephrotoxic with long-term use.

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Section: Aspirinmentioning

confidence: 76%

Common Analgesic Agents and Their Roles in Analgesic Nephropathy: A Commentary on the Evidence

Yaxley

2016

Korean J Fam Med

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“…9,12 Compared to non-aspirin NSAIDs, aspirin has a lower risk of decreasing renal blood flow and GFR and does not increase the blood pressure significantly. 25,43,44 Most of the literature indicates that aspirin alone is not associated with increased risk of kidney injury, 19,20,[45][46][47] even among heavy users to treat rheumatoid conditions, [48][49][50][51] but a few other studies have shown conflicting results. 52,53 Furthermore, high intake of non-aspirin NSAIDs was associated with a nine-fold increased risk of developing end-stage renal disease (ESRD), whereas no increased risk was observed in the frequent aspirin users.…”

Section: Potential Toxicitiesmentioning

confidence: 99%

“…60 The aspirin dose used for its cardioprotective effects is usually lower than the dose used for analgesic purposes although it is generally safe even among heavy users. [48][49][50][51] Secondly, due to the association between aspirin and Reye's syndrome, it is recommended that aspirin not be used in children and adolescents with varicella or influenza-like symptoms. 61 The incidence of Reye's syndrome is low, and withholding aspirin from children with viral illness symptoms should minimize the risk.…”

Section: Potential Toxicitiesmentioning

confidence: 99%

Use of anti-inflammatory analgesics in sickle-cell disease

2017

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Summary What is known and objective Nonsteroidal anti-inflammatory drugs (NSAIDs) have been commonly used to treat pain in sickle cell disease (SCD), but NSAID use is associated with renal, gastrointestinal, and cardiovascular toxicities. Our objective was to evaluate the use of aspirin and non-aspirin NSAIDs in SCD. Comment Despite analgesic and anti-inflammatory benefits in SCD, non-aspirin NSAIDs are associated with renal, cardiovascular and gastrointestinal toxicities in this patient population. Aspirin may have less renal and cardiovascular toxicities. The different side effect profile of NSAIDs is related to the COX-1/COX-2 selectivity at their therapeutic doses. Individual risk factors and genetic biomarkers should be considered when selecting appropriate NSAIDs and their dose. What is new and conclusion NSAIDs have the potential to be an important component of pain regimens in SCD, but the use of NSAIDs should be individualized based on potential side effects and patient risk factors and the lowest effective dose should be prescribed with proper monitoring in patients with SCD.

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“…These patients only had some minor abnormalities in kidney function tests and none of them exhibited any clinically significant impairment of renal function [287]. Each of them had consumed more than 5 kg (!)…”

Section: Analgesic Nephropathymentioning

confidence: 99%

Toxicity and Drug Safety

Schrör

2008

Acetylsalicylic Acid

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Aspirin and Analgesic Nephropathy

Cited by 52 publications

References 35 publications

Common Analgesic Agents and Their Roles in Analgesic Nephropathy: A Commentary on the Evidence

Common Analgesic Agents and Their Roles in Analgesic Nephropathy: A Commentary on the Evidence

Use of anti-inflammatory analgesics in sickle-cell disease

Toxicity and Drug Safety

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