Bladder Urothelium in Analgesic-Associated Nephropathy—A Valuable Diagnostic Aid

Abstract

A brownish discoloration of the bladder mucosa on cystoscopy and the histological findings in a bladder biopsy specimen of submucosal vascular basement membrane thickening, pigment or chronic inflammatory changes in the absence of infection were present in various combinations in all our patients with analgesic-associated nephropathy. None of these findings was present in a control group of patients with other established causes of renal function impairment. More objective diagnostic aids may lead to a greater awareness and earlier diagnosis of this preventable cause of chronic renal failure.

Subepithelial haematoma of the renal pelvis (Antopol–Goldman lesion)

“…Fourie et al . reported that experimental analgesic abuse results in prominent renal vascular proliferation and our histopathological finding of prominent capillary blood vessels in the lamina propria of the renal pelvis is consistent with this report 5 . Levitt et al .…”