Pharmacological mechanisms of analgesic nephropathy

Abstract

Much remains to be done in the experimental field before a unifying concept on the pathogenesis, incidence, and implications of analgesic nephropathy can be enunciated. The situation in the experimental field is unresolved; too many factors require clarification before the critical experiment can be conducted to settle the matter once and for all. However, as there is now plentiful evidence to convince any reasonable physician that commonly available analgesics, when abused, carry a significant health risk, one may reasonably ask whether any further experimental evidence is needed? The object of this review is in no sense divisive, i.e., by pointing out discrepancies in the available data to thereby cloud the issue rather than resolve them. The problem of abuse lies properly in the field of public health education, and the first step to this would surely be an appropriate warning on the packaging of all commonly used analgesics. For future research, however, government health authorities should be guided in their preclinical testing requirements for mild antiinflammatory analgesics, and enough is now known to draw up guidelines for good laboratory practice in this field.