Analgesic Use and Kidney Disease

The article by Gonwa et al, in this issue of the Archives (see p 462), suggests that analgesic use is an important cause of chronic renal failure in North Carolina. That conclusion agrees with data published in recent years concerning the importance of analgesic-induced renal failure (so-called analgesic nephropathy) in the United States. 1-3 If the incidence of analgesic nephropathy is as high as these collected data suggest (and there is no reason to suspect that it is not), then a considerable public health problem has been identified. Analgesic nephropathy, unlike almost all other causes of chronic renal failure, is both a preventable and a treatable disease. It is a treatable disease because it obviously does not develop if the responsible analgesic(s) is not taken in the required dosage. Its recent identification as an important public health problem should, therefore, generate efforts directed toward its prevention. Such efforts should include