Nephrology Dialysis Transplantation, Vol 14, Issue 1 109-112, Copyright © 1999 by Oxford University Press
A Schwarz, L Preuschof and D Zellner
Background: Phenacetin was removed from the German
market in 1986 and was replaced mainly in analgesic compounds by
acetaminophen. Our objective was to examine the effect of this measure on
the incidence of analgesic nephropathy in light of the changes in other
end-stage renal diseases. Methods: We therefore
compared the proportion of renal diseases in all patients in all patients
starting dialysis treatment during three 18-month periods: 4/1982-9/193
(n=47); 1/1991-6/1992 (n=81); and 10/1995-3/1997 (n=76).
Results: On the one hand, the proportion of end-stage
analgesic nephropathy decreased significantly from 30% in 1981-1982 to 21%
in 1991-1992 and 12% in 1995-1997 (P=0.01). On the other hand, type II
diabetes increased significantly from 7% to 22% (P=0.01) and 29% (P=0.001).
Using the &khgr;2 distribution test to analyze
the frequencies of seven diseases at three different time intervals,
however, showed that the changes in renal-disease proportions between
1982-1983, 1991-1992 and 1995-1997 were not significantly independent.
There was a significant median age increase from 52 years (CI0.95 44-58) in
1982-1983 to 63 (CI0.95 55-67) in 1991-1992 and 63 (CI0.95 60-66) in
1995-1997 (P=0.003) for all patients starting dialysis but not for those
with analgesic nephropathy [59 (55-71) vs 64 (53-67) and 61 (50-72); n.s.].
Conclusions: The decrease of end-stage analgesic
nephropathy since 1983 may be partially due to the removal of phenacetin
from the German market in 1986. However, considering the general increase
in numbers of dialysis patients, their higher age and the increased
incidence of type II diabetes, the decrease in analgesic nephropathy is not
a statistically significant independent variable. Altered admittance
policies for dialysis treatment have yielded a new pattern of renal-disease
proportion which interferes with changes in the incidence of analgesic
nephropathy. Key words: analgesic mixtures; analgesic
nephropathy; dialysis treatment; end-stage renal disease; type II diabetes
ORIGINAL ARTICLES
Incidence of analgesic nephropathy in Berlin since 1983
Department of Nephrology, University Hospital Benjamin Franklin, Free University, Hindenburgdamm 30, D-12200 Berlin, Germany; Division of Nephrology, University Hospital Ulm, Ulm, Germany; Corresponding author
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