CoChat
Sign Up
Cited by 484Nephrotoxicity and Medicinal PlantsInflammatory mediators and NSAID effectsAcute Kidney Injury Research

Risk of Kidney Failure Associated with the Use of Acetaminophen, Aspirin, and Nonsteroidal Antiinflammatory Drugs

Open access
Perneger, Thomas V., Whelton, Paul K., Klag, Michael J.·1994·New England Journal of Medicine
DOI 10.1056/nejm199412223312502
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: People who take analgesic drugs frequently may be at increased risk of end-stage renal disease (ESRD), but the extent of this risk remains unclear. METHODS: We studied 716 patients treated for ESRD and 361 control subjects of similar age from Maryland, Virginia, West Virginia, and Washington, D.C. The study participants were interviewed by telephone about their past use of medications containing acetaminophen, aspirin, and other nonsteroidal antiinflammatory drugs (NSAIDs). For each analgesic drug, the average use (in pills per year) and the cumulative intake (in pills) were examined for any association with ESRD. RESULTS: Heavier acetaminophen use was associated with an increased risk of ESRD in a dose-dependent fashion. When persons who took an average of 0 to 104 pills per year were used for reference, the odds ratio of ESRD was 1.4 (95 percent confidence interval, 0.8 to 2.4) for those who took 105 to 365 pills per year and 2.1 (95 percent confidence interval, 1.1 to 3.7) for those who took 366 or more pills per year, after adjustment for race, sex, age, and intake of other analgesic drugs. When persons who had taken fewer than 1000 pills containing acetaminophen in their lifetime were used for reference, the odds ratio was 2.0 (95 percent confidence interval, 1.3 to 3.2) for those who had taken 1000 to 4999 pills and 2.4 (95 percent confidence interval, 1.2 to 4.8) for those who had taken 5000 or more pills. Approximately 8 to 10 percent of the overall incidence of ESRD was attributable to acetaminophen use. A cumulative dose of 5000 or more pills containing NSAIDs was also associated with an increased odds of ESRD (odds ratio, 8.8), but the use of aspirin was not. CONCLUSIONS: People who often take acetaminophen or NSAIDs have an increased risk of ESRD, but not those who often take aspirin.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1056/nejm199412223312502

Cites

15 of 15 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Chronic paracetamol use also causes renal damage; a case-control study of 1,077 frequent users found a dose-dependent relationship between heavier paracetamol use and increased risk of end-stage renal disease.

    “Renal damage is also produced by chronic use of paracetamol; in a case-control study involving 1,077 subjects who frequently took paracetamol, a dose-dependent relationship between heavier paracetamol use and an increased risk of end-stage renal disease was demonstrated (160).”

    From Paracetamol: New Vistas of an Old Drug (2006) · cites this paper as [160]

    Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. [1]1. Spühler O, Zollinger HU. Die chronisch-interstitielle Nephritis. Z Klin Med 1953;151:1-50.

Cited by

Sorted by citations

Related

Authors
Perneger, T. V., Whelton, P. K., & Klag, M. J.
Affiliations
  • University of Geneva (CH)
  • Johns Hopkins University (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1994-12-22
Volume
331
Issue
25
Pages
1675-1679
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199412223312502
OpenAlex
W2320758398
Cited by
484
References
15
Citations by year
2026: 3 · 2025: 5 · 2024: 18 · 2023: 6 · 2022: 7 · 2021: 9 · 2020: 21 · 2019: 19 · 2018: 11 · 2017: 10 · 2016: 16 · 2015: 17 · 2014: 17 · 2013: 20 · 2012: 20
FWCI
20.58
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Agency for Healthcare Research and Quality (R03-HS06978-01)
  • National Center for Research Resources (5MOIRR00722, RR 00035)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Nephrotoxicity and Medicinal Plants
  • Health Sciences › Medicine › Pharmacology › Inflammatory mediators and NSAID effects
  • Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
Keywords
end-stage renal disease, renal failure, paracetamol, aspirin, nonsteroidal anti-inflammatory drugs, analgesic use, dose-response relationship, attributable risk, drug-induced nephrotoxicity
MeSH terms
Acetaminophen, Adult, Anti-Inflammatory Agents, Non-Steroidal, Aspirin, Drug Utilization, Female, Humans, Kidney Failure, Chronic, Male, Middle Aged, Risk Factors, Causality, Confidence Intervals, Odds Ratio, Case-Control Studies

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review