Estimated methods of predicting risk of analgetic interstitial renal disease


Cite item

Full Text

Abstract

Aim. Screening of renal pathology and investigation of its dependence on intake of metamisol, the risk of nephritis associated with metamisol. Material and methods. The study included 1446 inpatients (mean age 49.63 ± 0.43 years, 690 males - 48%, 756 females - 52%). Analysis of the urine, tests for urea, blood creatinine, estimation of glomerular filtration rate were made. Metamisol doses and duration of analgetic treatment were controlled in 658 patients. Statistical processing was made with Statistica 6.0 soft. Results. Of 1446 examinees, 346 (23.9%) patients took analgetics. Out of 98 patients treated with metamisol, 34(34.7%) had pathology of urinary sediment, 18 (18.4%) had suppression of renal function (RF) while in patients untreated with analgetics this percentage was 7.4 and 16.1%, respectively, p < 0.05. In intake of metamisol from 0.5 to 5.0 kg and more changes in urine analysis parameters and regress of RF were more prominent than in intake up to 0.5 kg (p<0.05). Application of nonlinear logistic regression analysis provided equations of logistic regression making it possible to assess probability of changes in urine analysis and renal function decline depending on the drug dose and duration of its intake. Conclusion. Inpatients often take analgetic drugs, especially metamisol. Its high doses are associated with risk of renal function decline and pathology of urinary sediment. Equations of calculation of renal affection risk in administration of metamisol are presented.

About the authors

M M Batiushin

ГОУ ВПО Ростовский государственный медицинский университет Росздрава

O V Dmitrieva

ГОУ ВПО Ростовский государственный медицинский университет Росздрава

V P Terent'ev

ГОУ ВПО Ростовский государственный медицинский университет Росздрава

K S Davidenko

ГОУ ВПО Ростовский государственный медицинский университет Росздрава

References

  1. Шилов Е., Андросова С. Лекарственные поражения почек. Врач 2002; 6: 47-49.
  2. Nanra R. S. Analgesic nephropathy in the 1990s-an Australian perspective. Kidney Int. Suppl. 1993; 42 (7): 86-92.
  3. Gault M. H., Barrett B. J. Analgesic nephropathy. Am. J. Kidney Dis. 1998; 32 (3): 351-360.
  4. Perneger Т. V., Whelton Р. K., Klag M. J. Risk of kidney failure associated with the use of acetaminophen, aspirin, and nonsteroidal antiinflammatory drugs. N. Engl. J. Med. 1994; 331: 1675-1679.
  5. Sandier D. P., Burr F. R., Weinberg C. R. Nonsteroidal anti-inflammatory drugs and the risk for chronic renal disease. Ann. Intern. Med. 1991; 115 (3): 165-172.
  6. Ohno I. Drug induced nephrotic syndrome. Nippon Rinsho 2004; 62 (10): 1919-1924.
  7. Schwarz A. Analgesic-associated nephropathy. Klin. Wschr. 1987; 65 (1): 1-16.
  8. Keusch G., Neftel K. A. Frequent problems of non-steroidal antirheumatic agents in old age. Schweiz. Med. Wschr. 1988; 118 (12): 438-446.
  9. Nanra R. S. Clinical and pathological aspects of analgesic nephropathy. Br. J. Clin. Pharmacol. 1980; 2 (10): 359-368.
  10. Mackinnon В., Boulton-Jones M., McLaughlin K. Analgesic-associated nephropathy in the West of Scotland: a 12-year observational study. Nephrol. Dial. Transplant. 2003; 18 (9): 1800-1805.
  11. Петричко M. И. Нефротоксичность (обзор литературы). Дальневост. мед. журн. 1996; 2: 71-75.
  12. Шулутко Б. И. Нефрология 2002, современное состояние проблемы. СПб.: Ренкор; 2002.
  13. Pintér I., Mátyus J., Czégány Z. et al. Analgesic nephropathy in Hungary: the HANS study. Nephrol. Dial. Transplant. 2004; 19: 840-843.
  14. Elseviers M. M., De Broe M. E. A long-term prospective controlled study of analgesic abuse in Belgium. Kidney Int. 1995; 48 (6): 1912-1919.
  15. Thieler H., Schafer W. The diagnosis of analgesic nephropathy. Z. Ges. Inn. Med. 1988; 43 (17): 499-504.
  16. Верткин А. Л., Тополянский А. В., Гирель О. И. Сравнительная эффективность и безопасность нестероидных противовоспалительных препаратов на догоспитальном этапе. Леч. врач 2004; 7: 35-37.
  17. Страчунский Л. С., Козлов С. Н. Нестероидные противовоспалительные средства. 2-е изд. Смоленск; 1997.
  18. Lawson D. Н. Analgesic consumption and impaired renal function. J. Chron. Dis. 1973; 26 (1): 39-45.
  19. Козловская Л. В., Николаев А. Ю. Учебное пособие по клиническим лабораторным методам исследования. 2-е изд. М.: Медицина; 1984.
  20. Folin О., Wu Н. A system of blood analysis. J. Biol. Chem. 1919; 38: 81.
  21. Залькалнс Я. П., Журавлева Н. Н. Эпидемиологический аспект хронических поражений почек лекарственного происхождения. Тер. арх. 1990; 6: 62-65.

Copyright (c) 2008 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies