Any Urologists out there?? Re: acetaminophen

[bullethead]

I've seen some articles lately regarding the risk of kidney failure relative to long term use of acetaminophen. I may need to take 500-1500mg per day for a while regularly (maybe forever). I have some hydro but otherwise normal function. Any thoughts appreciated. I understand any and all information shared is for my "entertainment purposes only" and is in no way to be used as a diagnosis, etc...

 

[HBO MD]

In the absence of associated liver problems ; a very safe drug. However, when taken chronically, any drug may contribute to problems due to to accumulated metabolites, long term toxicity etc.
If your creatinine clearance is less than 10 ml/min, decrease frequency to only 8 hourly, as the metabolites may accumulate.

This post is not consultative, binding, or anything else in any galaxy.

 

[TSandM]

Out of curiosity, because I hadn't heard of this, I spent a little time searching for papers. Most of what I found dated back to 2001, when a Swedish study was done of dialysis patients. It's not a very good study from a methodological standpoint, and it found essentially a doubling of the risk of developing renal failure in people who were high consumers of acetaminophen. However, there was no effort made to identify the condition for which people had been TAKING the acetaminophen (which condition might have contributed to the renal failure, as in lupus or other autoimmune conditions which can cause painful joints and affect the kidneys). Given that the lifetime risk of developing renal failure requiring dialysis is quite low, unless you have a condition affecting your kidneys (eg. diabetes), I would say that a doubling of a very low risk, determined from retrospective studies, is not enough to concern me greatly about acetaminophen use.

 

[bullethead]

I should have saved the link, what I was reading was from the newengland journal of medicine, but with my swiss cheese memory may have been referring to the same study. THX scott

 

[TSandM]

The Swedish study appears to have been published in NEJM: NEJM -- Acetaminophen, Aspirin, and Chronic Renal Failure

 

[HBO MD]

Good spotting guys !
But I have to agree. Mechanistically this is rather thin. Also, all patients had pre existing renal disease and the association was with etiologies which are classically progressive.