Clinical features

There may be few symptoms before the onset of chronic renal failure.

Failure to concentrate the urine sufficiently is an early consequence of the papillary lesions. The excretion of necrotic papillae may result in renal colic and gross haematuria.

Secondary tubular acidosis may result in renal stone formation.

Analgesic nephropathy is usually associated with the following:

• chronic pain e.g. arthritis } these may be the reason
• chronic headaches } for the analgesic use
  
  
• gastrointestinal complaints } another complication of analgesic abuse
  
  
• anaemia } the result of the renal
• hypertension } damage
• bladder cancer (associated in 10% of cases)

Pyuria is invariable but often sterile.

Urinary tract infections are common complications.