| Non-contrast-enhanced computerized tomography and analgesic-related kidney disease: report of the national analgesic nephropathy study. | |
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MedLine Citation:
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PMID: 16611714 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Previous studies suggested that the non-contrast-enhanced computerized tomography (CT) scan is a highly reliable tool for the diagnosis of analgesic-associated renal disease. However, this issue has not been addressed in the US population. A total of 221 incident patients with ESRD from different regions of the United States underwent a helical CT scan and detailed questioning about drug history. Specific renal anatomic criteria were developed to determine whether a constellation of CT findings (small indented calcified kidneys [SICK]) is linked to analgesic ingestion. For approximating use before the onset of renal disease, only analgesic ingestion at least 9 yr before starting dialysis was considered relevant. Fifteen patients met the criteria for SICK. This represented 7% of the enrolled patients and approximately 1% of the total ESRD population. There was a significant increase in the estimated risk among patients with a history of heavy aspirin ingestion (odds ratio [OR] 7.4 [95% confidence interval (CI) 1.2 to 43] for > or =1 kg lifetime; OR 8.8 [95% CI 1.2 to 66] for > or =0.3 kg/yr). Total analgesic ingestion of > or =0.3 kg/yr also was significantly associated with SICK (OR 8.2; 95% CI 1.5 to 45). These findings were accounted for largely by combination products that contained aspirin and phenacetin (used by three patients with SICK), which are no longer available. In addition, the CT finding of SICK was present only in a minority of heavy analgesic users, yielding a sensitivity of 5 to 26%. Findings of SICK are infrequent in the US ESRD population and do not occur among a sufficient proportion of heavy analgesic users to render the non-contrast-enhanced CT scan a sensitive tool to detect analgesic-associated kidney injury. |
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Authors:
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William L Henrich; Richard L Clark; Judith P Kelly; Vardaman M Buckalew; Andrew Fenves; William F Finn; Joseph I Shapiro; Paul L Kimmel; Paul Eggers; Larry E Agodoa; George A Porter; Samuel Shapiro; Robert Toto; Theresa Anderson; L Adrienne Cupples; David W Kaufman |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2006-04-12 |
Journal Detail:
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Title: Journal of the American Society of Nephrology : JASN Volume: 17 ISSN: 1046-6673 ISO Abbreviation: J. Am. Soc. Nephrol. Publication Date: 2006 May |
Date Detail:
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Created Date: 2006-04-25 Completed Date: 2006-11-02 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 9013836 Medline TA: J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 1472-80 Citation Subset: IM |
Affiliation:
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Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA. henrich@uthscsa.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Analgesics* Contrast Media Dialysis / statistics & numerical data Female Humans Incidence Kidney Failure, Chronic / epidemiology*, rehabilitation, ultrasonography* Male Middle Aged Prevalence Reproducibility of Results Risk Assessment / methods* Risk Factors Sensitivity and Specificity Tomography, X-Ray Computed / statistics & numerical data* United States / epidemiology |
| Grant Support | |
ID/Acronym/Agency:
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N01-DK-02400/DK/NIDDK NIH HHS; N01-RR-07122/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Analgesics; 0/Contrast Media |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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