Analgesic-associated nephropathy and transitional cell carcinoma of the urinary tract

Epidemiologic studies from Europe suggest that patients with analgesic-associated nephropathy have an increased risk of developing transitional cell carcinoma of the urinary tract. We did a similar epidemiologic study supporting this association. Six of 115 cases of transitional cell carcinoma diagnosed over 3 years had analgesic-associated nephropathy. The patients were predominantly female, younger, and had renal pelvis tumors instead of bladder tumors (P < 0.002), and mortality rate was higher (P < 0.05). In a historical prospective study, 146 patients with interstitial nephritis diagnosed between 1974 and 1976 were divided into those with and those without analgesic-associated nephropathy. In 4 of 84 patients with analgesic-associated nephropathy transitional cell carcinoma has developed. None of the 98 patients without analgesic associated nephropathy have developed transitional cell carcinoma (P< 0.001). These data strongly incriminate analgesic abuse as a risk factor for the development of transitional cell carcinoma.