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Nephrol Dial Transplant (1994) 9: 1371-1376
© 1994 European Renal Association-European Dialysis and Transplant Association

other

End-stage renal failure due to analgesic nephropathy, its changing pattern and cardiovascular mortality

F. P. Brunner, Neville H. Selwood and on behalf of the EDTA-ERA Registry Committee

Department für Innere Medizin, Universität Basel, Switzerland; and EDTA Registry, St Thomas' Hospital London, UK

Correspondence and offprint requests to: Correspondence and offprint requests to: Dr Neville Selwood, EDTA Registry, St Thomas' Hospital, London SE1 7EH, UK

The changing pattern of prevalence and age distribution of analgesic nephropathy as a cause of end-stage renal failure (ESRF) in patients on RRT was analysed using the EDTA-ERA Registry's files. Comparing 1990 to 1981, the percentage of patients with analgesic nephropathy decreased in many European countries and the Registry's average came down from 3 to 2%. The highest prevalence was noted for Switzerland, which showed a decrease from 28 in 1981 to 12% in 1990. During the same interval the age distribution shifted to the right with an increase in median age from 57 to 63 at start of RRT for analgesic nephropathy. In Switzerland the age-specific acceptance rate to RRT for patients with analgesic nephropathy decreased to less than 1/3 in the age cohorts below 55 but increased in those aged 65 or older. This increase in the elderly cohorts appeared to be related to the growing acceptance rate to RRT of elderly patients in general rather than to an increasing incidence of ESRF due to analgesic nephropathy. Mortality in general and death rates due to cardiovascular causes were found not to differ in RRT patients with analgesic nephropathy from that of other standard primary renal diseases (excluding diabetic nephropathy and systemic diseases). Some 20 years after withdrawal of phenacetin from the analgesic market, analgesic nephropathy all but disappeared as a cause of ESRF in Sweden and Denmark, and the same may be expected to occur in countries like Switzerland, Belgium, and others in the not too far distant future.

Keywords: EDTA Registry; analgesic nephropathy; cardiovascular mortality on renal replacement therapy; epidemiology of end-stage renal failure due to analgesic nephropathy


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