Aspirin and renal disease.

Historic data has suggested a relationship between aspirin ingestion and the subsequent occurrence of renal papillary necrosis. In most case reports, analgesic mixtures containing aspirin, phenacetin, and caffeine were taken. This resulted in the term "analgesic nephropathy." In clinical studies, phenacetin has been the major common denominator, whereas experimental data in rats implicate aspirin as the major nephrotoxin. Except with massive doses, attempts at producing nephrotoxicity in laboratory animals with phenacetin have failed; however, a high proportion of rats fed aspirin alone have developed renal papillary necrosis. Acute reversible effects of aspirin on renal function in patients with active lupus nephritis have been demonstrated. Data are presented in 46 patients who took aspirin continuously for 10 or more years (mean total dosage 35 kg) in whom there was no evidence of significant renal dysfunction. These data suggest that, while aspirin may cause minor histologic or functional renal abnormalities, it is unlikely that long-term salicylate consumption causes serious renal disease.