BACKGROUND: Analgesic-associated @entity8 (AAN) is an important and preventable cause of @entity177 ( @entity177 ). Although its incidence is falling in some countries, others are witnessing an increase in the number of new cases. METHODS: The aim of this study was to evaluate the natural history of AAN, determine the correlates of the rate of decline in renal function and examine factors conferring an increased risk of @entity204 or dialysis in such @entity1 . A prospective observational cohort study of all @entity1 with AAN attending a single-centre was conducted. RESULTS: Seventy-eight @entity1 (25 male), with at least 24 months of follow-up for analysis, were diagnosed as having AAN over the 10-year period 1989-1999. During follow up, the mean (+/-SD) rate of change in estimated @entity1011 clearance (ECC) was -1.2 ml/min/year (+/-5.28). By multiple linear regression three variables were found to independently predict the rate of deterioration in ECC; continuing analgesic use (P < 0.001), degree of @entity644 at presentation (P = 0.002) and male sex (P = 0.03). A Cox's model revealed a 6-fold increase in the hazard of reaching the combined end-point of @entity204 or dialysis in those @entity1 with AAN who continue to use analgesics. This was independent of the other two significant risk factors of pre-existing @entity455 (HR 3.93, 1.36-11.29) and ECC at presentation (HR 0.95, 0.91-0.98 per ml/min). CONCLUSIONS: In @entity1 with @entity177 due to AAN ongoing analgesic use, male gender and increasing @entity644 predict a more rapid decline in renal function. @entity1 who continue analgesics, those with pre-existing @entity455 and those with more advanced @entity8 at presentation, are at a significantly increased risk of reaching the combined end-point of @entity204 or end-stage @entity177 requiring dialysis. The design of this study, however, leaves it open to the criticism that selection bias may account for some of its effects, and as with all work on AAN the possible confounding issue of reverse causality is difficult to dismiss.

Analgesic-associated XXXX in the West of Scotland: a 12-year observational study.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity644 :: ('MESH:D011507', 'Disease') :: ['proteinuria'] @entity8 :: ('MESH:D007674', 'Disease') :: ['nephropathy', 'renal impairment'] @entity455 :: ('MESH:D014652', 'Disease') :: ['vascular disease'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure', 'chronic renal failure', 'CRF'] @entity1011 :: ('MESH:D003404', 'Chemical') :: ['creatinine'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity8 :: (MESH:D007674,Disease) :: ['nephropathy']
