镇痛药肾病

Analgesic nephropathy.

镇痛药肾病是指长期大量应用非甾体类抗炎药及其复方制剂造成的慢性肾小管间质性肾病和肾乳头坏死。起病隐匿,早期症状多不明显,可缓慢进展至终末期肾病,且没有特效治疗方法。目前本病无统一诊断标准,其发生率在不同国家和地区差异很大。本文综合分析近20余年来文献,对镇痛药的致病成分和镇痛药肾病的流行病学、发病机制和临床表现进行讨论,并尝试提出诊断建议和今后临床科研工作的重点。

Analgesic nephropathy is a slowly progressive disease caused by the long-term abuse of the non-steroidal antiinflammatory drugs or their mixtures. Pathologically, the analgesic nephropathy is characterized by chronic tubulointerstitial nephritis and renal papillary necrosis. In the early stage, the clinical characteristics are latent. With further progression of the disease, there are the nonspecific symptoms of end stage renal disease. There is no unified diagnosis standard about the disease. The incidence of analgesic nephropathy has great variation among different country. Based on the current literature, we discussed its pathogenesis, epidemiology, clinical manifestation, diagnosis and therapy.