Analgesic drugs causing kidney functional disturbances and histologically evident kidney derangements are reviewed. Today, not the pathological changes, which have dominated the scene of pathogenesis for analgesic nephropathies are in the foreground of investigative interest, but rather the biochemical interactions of analgesics or their metabolites in the renal cell and prospective epidemiologic studies. As the term 'phenacetin nephropathy' has been replaced by 'analgesic nephropathy', it seems likely that metabolic activation responsible for renal injury caused by analgesic mixtures will be of primary importance in furture investigations as well as the unravelling of immunogenic processes for a variety of analgesics and their metabolites.