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Analgesic-Associated Nephropathy and Transitional Cell Carcinoma of the Urinary Tract

THOMAS A. GONWA, M.D.; WAYNE T. CORBETT, V.M.D., Dr. P.H.; HARRY M. SCHEY, Ph.D.; and VARDAMAN M. BUCKALEW Jr., M.D.
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▸Requests for reprints should be addressed to: Vardaman M. Buckalew, Jr., M.D.; Bowman Gray School of Medicine, 300 South Hawthorne Road; Winston-Salem, NC 27103.


Winston-Salem, North Carolina


© 1980 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1980;93(2):249-252. doi:10.7326/0003-4819-93-2-249
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Epidemiologic studies from Europe suggest that patients with analgesic-associated nephropathy have an increased risk of developing transitional cell carcinoma of the urinary tract. We did a similar epidemiologic study supporting this association. Six of 115 cases of transitional cell carcinoma diagnosed over 3 years had analgesic-associated nephropathy. The patients were predominantly female, younger, and had renal pelvis tumors instead of bladder tumors (P < 0.002), and mortality rate was higher (P < 0.05). In a historical prospective study, 146 patients with interstitial nephritis diagnosed between 1974 and 1976 were divided into those with and those without analgesic-associated nephropathy. In 4 of 84 patients with analgesic-associated nephropathy transitional cell carcinoma has developed. None of the 98 patients without analgesic associated nephropathy have developed transitional cell carcinoma (P < 0.001). These data strongly incriminate analgesic abuse as a risk factor for the development of transitional cell carcinoma.

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