Acetophenetidin Nephritis and Papillary Necrosis

Before 1960 the association of interstitial nephritis and papillary necrosis with the chronic ingestion of kilogram quantities of acetophenetidin (Phenacetin) was described almost exclusively by Swiss and Scandinavian authors. Since that date a number of authors outside of Europe have drawn attention to the possible effects of acetophenetidin, and in all probability the condition is not as rare in other countries as was formerly believed. At present there is a great deal of controversy concerning various aspects of the relationship of acetophenetidin ingestion and renal disease. Thus, the exact role of acetophenetidin or its degradation products in the production of renal lesions is uncertain1; the importance of the different methods of manufacture of acetophenetidin and the resulting contaminating compounds in the pathogenesis of the renal disease is being debated2; the specificity of the histological picture produced by prolonged ingestion of acetophenetidin is open to doubt3,4; the role