Chronic renal failure and end-stage renal disease in northwest North Carolina. Importance of analgesic-associated nephropathy.

A retrospective study was undertaken to determine the extent to which analgesic-associated nephropathy (AAN) causes chronic renal failure (CRF) and end-stage renal disease (ESRD). Of 363 cases of CRF diagnosed between 1974 and 1976, 48 were caused by AAN; 14 of 140 cases of ESRD were caused by AAN. Of the 14 patients with ESRD from AAN, 12 initially had ESRD and two progressed to ESRD while continuing consumption of analgesics. The remaining 34 patients who had AAN with CRF discontinued using analgesics and have not progressed to ESRD. Thus, 34 of 36 patients with AAN-CRF who initially did not have ESRD discontinued use of analgesics and have not progressed to ESRD. We conclude that AAN causes a large percentage of CRF and ESRD in our patient population. Early recognition of this entity can prevent progression to ESRD if analgesic consumption is discontinued.