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January 1, 1982

Analgesic Nephropathy in 1981: Which Drug Is Responsible?

JAMA. 1982;247(1):64-65. doi:10.1001/jama.1982.03320260048032

In 1953, Spühler and Zollinger from Switzerland described a group of patients with chronic interstitial nephritis in whom there appeared to be an association between the renal disease and the ingestion of large quantities of certain analgesic drugs. This report was followed by several others from other countries in Europe and, ultimately, from South Africa, Australasia, and North America supporting this proposed drug-disease association. In the 1950s and 1960s there raged in the literature (also manifest at international medical congresses) debate and controversy concerning the possible relationships between "over-the-counter" pain-relieving medication and kidney disease. The major issues under discussion were (1) Was there, indeed, a causal relationship between analgesic drugs and renal disease, or was there merely a coincidental association between certain types of renal disease and the desire to consume analgesics (eg, some proposed that the renal disease was no different from chronic bacterial pyelonephritis)? (2) If there was