[Causes and consequences of long term consumption of phenacetin-containing analgesics, from the urologist's point of view (author's transl)].

In the last two decades reports concerning analgesic nephropathies have been presented from most industrial countries. Today, there is no doubt concerning a causal association between long-term consumption of analgesics and renal failure. In a group of 274 urological patients, the reasons and consequences of long-term intake of phenacetin-containing compounds are herewith demonstrated. The reason for chronic consumption of analgesics is mainly headache, due to psychosomatic causes which had not been adequately treated. After an average latency period of 20 years, renal (papillary necrosis, chronic interstitial nephritis) and extrarenal manifestations appeared. Despite slow progression and low gradient symptoms, severe alterations could be determined at the first examination. Course and prognosis primarily depend on a successful cessation of analgesics and the elimination of the accompanying infection. In the last decade, an increase of transitional cell carcinoma induced by analgesics has been observed. 22 of our patients presented a tumor of the urothelium (i.e. 8%). A further increase of these specific cases is expected.