Reuters (KC) 01-Jan-07

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Painkillers do not raise risk of kidney disease: study

NEW YORK (Reuters Health) - Analgesics other than phenacetin are not associated with an increased risk of developing end-stage renal disease (ESRD) at a relatively young age, according to a study conducted in Germany. ESRD is the most advanced form of kidney disease.

Earlier studies associated phenacetin use with renal disease, the study team explains. Phenacetin was withdrawn from the U.S. market in the 1980s after it was implicated in kidney damage and cancer. However, the association of other analgesics with ESRD remains controversial.

Dr. Fokke J. van der Woude from Klinikum Heidelberg-Mannheim, Germany and colleagues investigated the issue in a population-based study involving 907 cases of ESRD in individuals younger than age 50 years who were matched to 3,622 healthy controls.

There was no association between later development of ESRD and use of all phenacetin-free analgesics together, analgesics with a single substance, or analgesics with multiple components, the researchers report in the online journal BioMedCentral-Nephrology.

Moreover, there was no significant difference in ESRD risk between high and low use of compounds with or without caffeine, and the lack of increased risk persisted when examining patients with different underlying diseases related to ESRD.

For most analgesics, in fact, there was a significantly lower risk of ESRD with low doses of analgesics used over a longer period of time, the report indicates.

"The results suggest that there is no association between ESRD and analgesic use in general, nor with the use of specific analgesics or combinations with or without additional caffeine in the age group below 50 years," the team concludes.

"Overall, our results lend support to the mounting evidence that phenacetin-free analgesics do not induce ESRD," the study team writes. They think the notion of "analgesic kidney disease" needs to be reevaluated.

SOURCE: BMC Nephrology, online December 5, 2007.

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