Analgesic abuse


Appropriate Tests


Creatinine, Urea, Electrolytes (serum).

MCS urine (microscopy and culture).

Renal failure - chronic






Renal papillary necrosis

MCS urine; collect any solid material passed in urine and submit (in formalin) for histopathological assessment (sloughed papilla).

Renal tubular acidosis


Renal tubulo-interstitial disorders


Urinary tract tumour, especially

  • Renal pelvis

Urine cytology. Fine needle aspiration biopsy, lesion biopsy, as appropriate.


Typically follows an acute overdose, but may result from prolonged use of smaller doses of paracetamol-containing analgesics, particularly in patients with pre-existing liver disease. Paracetamol level. Aspartate aminotransferase, Alanine aminotransferase, Gamma glutamyltransferase.

See Hepatic failure.