Schwarz A, Pommer W, Kühn-Freitag G, Keller F, Molzahn M, Offermann G
Schweiz Med Wochenschr. 1985 Jun 8;115(23):790-5.
The diagnosis of analgesic-associated nephropathy (AAN) may be missed because of the patients denial or regular analgesic intake. We therefore performed a cross-sectional study of the 144 patients of our hemodialysis center to investigate differences between the 48 patients with AAN (33%) and patients with other kidney diseases who served as controls. The aim was to find other attributes of analgesic users relating to social history, habits and morbidity. Dialysis patients with AAN were significantly older (60 +/- 10 versus 52 +/- 15 years) and more frequently women (65% versus 37%) compared with controls; they often had a family history of analgesic abuse. Comparison with an age-matched control group of hemodialysis patients with other kidney diseases showed that AAN patients smoked, used hypnotics and laxatives, and required prescriptions significantly more frequently; they were less frequently willing to undergo renal transplantation. With regard to accompanying diseases, they suffered significantly more often than the age-matched controls from anemia, renal osteodystrophy, peptic ulcer disease, diverticulosis, hemorrhoids, atrial fibrillation, coronary heart disease, hyperlipidemia, carpal tunnel syndrome, and urinary tract infections. The characteristic pattern of habits, social history and accompanying diseases may facilitate the diagnosis of AAN even in cases where analgesic consumption is denied.
由于患者否认或持续服用镇痛药，镇痛剂相关性肾病（AAN）的诊断可能会被漏诊。因此，我们对血液透析中心的144例患者进行了一项横断面研究，以调查48例AAN患者（占33%）与作为对照的其他肾病患者之间的差异。目的是找出镇痛药使用者在社会史、习惯和发病率方面的其他特征。与对照组相比，AAN透析患者年龄显著更大（60±10岁对52±15岁），女性比例更高（65%对37%）；他们常有镇痛药滥用家族史。与年龄匹配的患有其他肾病的血液透析患者对照组相比，AAN患者吸烟、使用催眠药和泻药以及需要处方的频率显著更高；他们接受肾移植的意愿较低。关于伴发疾病，与年龄匹配的对照组相比，他们患贫血、肾性骨营养不良、消化性溃疡病、憩室病、痔疮、心房颤动、冠心病、高脂血症、腕管综合征和尿路感染的频率显著更高。即使在患者否认服用镇痛药的情况下，习惯、社会史和伴发疾病的特征模式也可能有助于AAN的诊断。
