Acute Effects of Acetaminophen on Renal Function and Urinary Excretion of Some Proteins and Enzymes in Patients with Kidney Disease
Open accessAbstract
The acute effects of acetaminophen, a commonly used as analgesic drug, upon the urinary excretion of some proteins and enzymes as markers of kidney damage, was investigated. Patients with chronic glomerulonephritis (GN) and Balkan endemic nephropathy (BEN), having kidney vulnerable to toxic drugs, were enrolled in the study. Timed urine specimens were collected: before drug administration, and in 3-hour periods for 24 hours after an oral dose of 2 g of acetaminophen. Urinary excretion of albumin before acetaminophen treatment was significantly higher in patients with GN and BEN than in healthy adults, however, beta 2-microglobulin excretion was increased in BEN patients only. Urinary excretion of creatinine markedly increased immediately after acetaminophen ingestion. Urinary excretion of total protein and albumin was not changed after acetaminophen administration. However, acetaminophen treatment produced a significant increase in beta 2-microglobulin excretion in patient with BEN and GN, and in clinically healthy members of nephropathic families. Excretion of aminopeptidase N (APN) activity before acetaminophen treatment was significantly higher in patients with GN, however, NAGA excretion was higher in both GN and BEN patients than in healthy controls. After acetaminophen administration urinary excretion of APN, dipeptidylpeptidase IV (DPP IV), gamma-glutamyltranspeptidase (GGT) and N-acetyl-beta-D-glucosaminidase (NAGA) did not increase significantly in any group studied. This study has shown that urinary excretion of APN, DPP IV, NAGA and GGT, as markers of kidney brush border and lysosomal damage, did not change after 2 g of acetaminophen taken orally. beta 2-microglobulin was a marker of acute acetaminophen nephrotoxicity in kidney disease patients and in clinically healthy adults from nephropathic families.
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Paracetamol should be considered a safe alternative to NSAIDs for mild-to-moderate pain in elderly patients and those with kidney disease, hypertension, or congestive heart failure.
“Paracetamol must be considered as a safe alternative to NSAIDs for the relief of mildto-moderate pain in elderly patients, in patients with kidney disease (144), hypertension (56,93,104,110,166,184,185,225), congestive heart failure (81,85,98,139,157).”
From Paracetamol: New Vistas of an Old Drug (2006) · cites this paper as [144]
Citation (144) is attached specifically to the recommendation for patients with kidney disease. The Discussion (page unavailable) instead reports kidney-damage markers after a 2 g dose in such patients and urges caution in their use of acetaminophen. (LLM, conf=0.90)
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- Authors
- Mitic-Zlatkovic, M., & Stefanovic, V.
- Venue
- Renal Failure
- Publisher
- Informa UK Limited
- Published
- 1999-01
- Volume
- 21
- Issue
- 5
- Pages
- 525-532
- ISSN
- 0886-022X (ISSN-L)
- 1525-6049
- OpenAlex
- W2089215863
- Cited by
- 14
- References
- 15
- Citations by year
- 2019: 1 · 2018: 1 · 2017: 1 · 2016: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Renal Failure (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Nephrotoxicity and Medicinal Plants
- Health Sciences › Medicine › Nephrology › Renal Diseases and Glomerulopathies
- Keywords
- paracetamol, nephrotoxicity, chronic glomerulonephritis, Balkan endemic nephropathy, urinary biomarkers, beta2-microglobulin, albuminuria, CD13, N-acetyl-beta-D-glucosaminidase, dipeptidyl peptidase IV, gamma-glutamyltranspeptidase, lysosomal damage, kidney disease
- MeSH terms
- Acetaminophen, Acute Disease, Enzymes, Glomerular Filtration Rate, Humans, Kidney, Kidney Diseases, Middle Aged, Proteinuria, Rural Population, Time Factors, Urban Population, Yugoslavia, Analgesics, Non-Narcotic
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