investigations
Last reviewed 01/2018
Investigations may reveal:
- MSU - sterile pyuria, haematuria
- FBC - microcytic anaemia
- U+Es - renal impairment
- intravenous urography - this will demonstrate established papillary necrosis
if present - this test is less used than previously
- computerised tomography - this is said to be the most sensitive test for
papillary necrosis (1)
- however a study of patients with ESRD (National Analgesic Nephropathy
Study [NANS]) in the United States evaluated the value of the non-contrast-enhanced
CT as diagnostic test for AN
- in this study the sensitivity of the noncontrast CT scan for the detection of analgesic-associated kidney injury was too low to be used as a routine test (3)
- however a study of patients with ESRD (National Analgesic Nephropathy
Study [NANS]) in the United States evaluated the value of the non-contrast-enhanced
CT as diagnostic test for AN
Reference:
- 1) Elseviers MM, Waller I, Nenoy D et al. Evaluation of diagnostic criteria for analgesic nephropathy in patients with endstage renal failure: results of the ANNE study. Nephrol Dial Transplant 1995;10: 808-814.
- 2) Prescribers' Journal 2000; 40 (2): 151-156
- 3) Henrich WL, Clark RL, Kelly JP, Buckalew VM, Fenves A, Finn WF, Shapiro JI, Kimmel PL, Eggers P, Agodoa LE, Porter GA, Shapiro S, Toto R, Anderson T, Cupples LA, Kaufman DW : Non-contrast-enhanced computerized tomography and analgesic-related kidney disease: Report of the national analgesic nephropathy study. J Am Soc Nephrol 2006; 17: 1472-1480