EARLY DETECTION OF NEPHROTOXICITY IN PATIENTS WITH MEDICATIONOVERUSE HEADACHE (MOH)

Drita Yzeiri Havziu, Biljana Gjorgjeska, Dragana Cvetkovska, Sefedin Bilalli, Igor Nikolov

Abstract

Excessive drug use causes Medication-overuse headache (MOH) which can be manifested of chronic daily headaches, occurring monthly 15 or more days, when the medicament is used redundantly for more than three months. Recent studies concerning the epidemiology of drug-induced disorders suggest that increased risk of nephrotoxicity appears in a group of patients who abuse NSAIDs. The aim is to confirm the early phase of nephrotoxicity in patients with (MHO), divided in two groups: first group users of non-steroidal anti-inflammatory drugs (NSAIDs) and second group that use combinations of various analgesics, compared with 80 healthy individuals. Besides conventional markers of renal functioning (serum/urine creatinine determined by Jaffe methods, enzymatic assay for urea serum and GFR by Cockcroft Gaunt formula), we will use colorimetric method determining N-acetyl–ß-d-glucosaminidase–NAG, Alanin Aminopeptidase-AAP in urine, IFCC for Gamma-glutamyltransferase- YGT. Imunoturbodimetric assay for determination of urinary albumin, microalbuminuria and a1-microglobulinwill be used. After 12 months treatment oftwo groups of patients, no changes were found in the serum creatinine, serum urea and GFR, but extremely statistical difference (p <0.01)in the values of specific biomarkers, NAG, AAP, GGT, microalbuminuria in all patients, especially with combined therapiein the comparison with healthy patients. We concluded changes on the glomerular and tubular level, despite the normal values of all the assayed conventional markers for renal function, We can’t confirm by nephrotoxicity, but if we follow the elevation of the level of the specific biomarkers, we will have an overview of the real state of functioning of the kidneys in patients with MHO.

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