Analgesic nephropathy and papillary necrosis.

IT SEEMS likely from human and animal studies (Kincaid-Smith, 1967; Abrahams & Levin, 1967; Kincaid-Smith, Saker & McKenzie, 1968) that kidney damage resulting from a high analgesic intake in man and in animals can be explained on the basis of papillary necrosis followed by subsequent atrophy of adjacent cortical tissue. This concept makes it much easier to understand the possible mechanisms whereby analgesiccompounds may damage the kidney. Many substances are present in very high concentrations in the papilla, and it is reasonable to postulate that damage to the papilla may be related to high concentrations of some breakdown products of analgesic drugs. This paper discusses possible mechanisms which may result in papillary necrosis in different conditions, with special reference to papillary necrosis associated with a high intake of various analgesic compounds.