11. Chronic use of phenacetin is known to lead to analgesic nephropathy characterized by renal papillary necrosis. 12. Due to low cost phenacetin is used for research into the physical and refractive properties of crystals. 13. Paracetamol is the major metabolite of phenacetin and may contribute to kidney injury through a specific mechanism. 14. However, unlike phenacetin , acetanilide and their combinations, paracetamol is not considered carcinogenic at therapeutic doses. 15. A follow-up paper by Brodie and Axelrod in 1949 established that phenacetin was also metabolised to paracetamol. 16. In the 1950s, Sp�hler and Zollinger reported an association between kidney injury and the chronic use of phenacetin . 17. This condition was dubbed analgesic nephropathy and was attributed to phenacetin , although no absolute causative role was demonstrated. 18. NSAIDs in combination with excessive use of phenacetin and / or paracetamol ( acetaminophen ) may lead to analgesic nephropathy. 19. This was accompanied by the commercial demise of phenacetin , blamed as the cause of analgesic nephropathy and hematological toxicity. 20. In most areas, its incidence has declined sharply since the use of phenacetin fell in the 1970s and 1980s.
