Review Article | DOI: https://doi.org/10.31579/2690-4861/1162
Internal medicine senior specialist, Revive medical center, Qatif, KSA.
*Corresponding Author: Shimaa Hamad Elneel Ahmed Elrayah., Internal medicine senior specialist, Revive medical center, Qatif, KSA.
Citation: Ahmed Elrayah SHE (2026), Analgesic Nephropathy In 2026: Risk Factors, Pathophysiology, And Prevention Strategies, International Journal of Clinical Case Reports and Reviews, 37(3); DOI:10.31579/2690-4861/1162
Copyright: © 2026, Shimaa Hamad Elneel Ahmed Elrayah. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 09 September 2026 | Accepted: 28 September 2026 | Published: 09 October 2026
Keywords: Analgesic nephropathy; chronic tubulointerstitial nephritis; renal papillary necrosis
Analgesic nephropathy (AN) remains a critical yet under-recognized cause of chronic tubulointerstitial nephritis and progressive renal injury in contemporary internal medicine. While historically associated with phenacetin abuse, the clinical landscape in 2026 is driven by chronic, high-dose combination regimens of nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (paracetamol), often augmented by caffeine or codeine. This narrative review addresses three primary objectives: summarizing current epidemiological trends and risk factors, highlighting the synergistic nephrotoxicity of combination analgesics and host hemodynamic vulnerabilities; detailing the dual-pathway pathophysiological mechanisms that cause medullary vasoganglion ischemic injury and toxic metabolite-induced oxidative stress, progressing to renal papillary necrosis (RPN) and chronic tubulointerstitial nephritis (CIN); and presenting a practical, ward-based action plan for internists encompassing targeted admission medication reconciliation, protection of renal autoregulation, safe inpatient multimodal pain protocols, and patient education. Early identification and systematic de-prescribing remain the cornerstone of preventing irreversible end-stage kidney disease.
Analgesic nephropathy (AN) is a distinct form of chronic tubulointerstitial nephritis (CIN) pathologically defined by renal papillary necrosis (RPN) and secondary cortical atrophy, resulting from long-term, cumulative consumption of combination analgesic agents [1,2]. Originally recognized in the mid-20th century in connection with phenacetin overuse, the systematic withdrawal of phenacetin from global markets led to a dramatic drop in classic high-incidence clusters of AN [3,4]. However, in 2026, the clinical perception that analgesic-induced kidney injury is a disease of the past is dangerously flawed [5]. Modern analgesic practices—characterized by widespread over-the-counter (OTC) accessibility, widespread self-medication for chronic pain, and fixed-dose multi-ingredient formulations—have sustained a major burden of drug-induced kidney disease [6,7]. Contemporary analgesic nephropathy presents major diagnostic challenges to general internists and hospitalists [8]. The clinical course is characteristically indolent and non-specific, with loss of renal function occurring silently over years [9,10]. Patients frequently present during hospital admissions for unrelated acute illnesses, at which point subtle acute-on-chronic kidney injury (AKI) is detected [11,12]. Because over-the-counter pain relievers are widely regarded by the public as harmless, patients rarely report their cumulative analgesic consumption unless specifically cross-examined during medication reconciliation [13,14]. This narrative review provides a comprehensive, up-to-date analysis of analgesic nephropathy in 2026, focusing on epidemiological shifts, modern risk factors, dual-pathway pathophysiological mechanisms, diagnostic imaging criteria, and actionable ward-based strategies for inpatient management and prevention.
The epidemiological profile of analgesic nephropathy has evolved significantly over the past three decades [15]. While historical AN was dominated by middle-aged women abusing phenacetin-containing powders, modern AN affects a broader demographic, including elderly individuals and patients suffering from chronic musculoskeletal disorders, osteoarthritis, low back pain, and refractory migraines [16,17]. Recent observational studies and renal registry data indicate that chronic NSAID and acetaminophen abuse accounts for 3% to 8% of all end-stage kidney disease (ESKD) cases globally, with higher proportions in health systems where multi-agent analgesics are sold without prescription [18,19].
2.1 Synergistic Toxicity of NSAID and Acetaminophen Combinations
The fundamental epidemiological hazard in modern AN stems from the synergistic nephrotoxicity of combination analgesic abuse [20]. Formulations combining an NSAID (e.g., ibuprofen, naproxen, diclofenac) with acetaminophen (paracetamol), often augmented by central adjuvants such as caffeine, codeine, or diphenhydramine, remain widely popular [21,22]. Clinical and epidemiological evidence confirms that habitual intake of combination analgesics confers a 2.5- to 3.8-fold higher risk of developing progressive CKD compared to single-agent therapy at equivalent doses [23,24]. Caffeine acts as an adenosine receptor antagonist and mild CNS stimulant, which not only enhances perceived pain relief but also fosters psychological dependency, driving habitual daily consumption [25,26]. A cumulative lifetime intake of ≥1.0 to 2.0 kilograms of active analgesic compounds, or continuous daily use for more than 3 to 5 years, represents the classic exposure threshold for structural medullary damage [27,28].
2.2 Vulnerable Host Populations and Hemodynamic Modifiers
The development and severity of analgesic nephropathy are modulated by host hemodynamic vulnerabilities [29]. In hospitalized patients, underlying medical comorbidities frequently amplify renal susceptibility to analgesic injury [30]. Advanced age (>65 years) is a major independent risk factor due to age-related nephron loss, reduced renal blood flow, and blunted autoregulatory capacity [31,32]. Patients with pre-existing CKD, diabetic nephropathy, congestive heart failure, hepatic cirrhosis, or volume depletion rely heavily on renal prostaglandin synthesis to maintain glomerular perfusion [33,34]. In the acute ward setting, the 'triple whammy' interaction represents a high-risk clinical scenario [35,36]. The simultaneous administration of an NSAID, a renin-angiotensin-aldosterone system (RAAS) blocker (ACE inhibitor or ARB), and a loop or thiazide diuretic severely compromises renal autoregulation [37,38]. Diuretics reduce extracellular volume; RAAS blockers abolish efferent arteriolar vasoconstriction; and NSAIDs inhibit prostaglandin-mediated afferent arteriolar vasodilation [39]. This convergence causes rapid drops in intraglomerular capillary pressure, precipitating ischemic acute tubular necrosis or acute-on-chronic kidney injury [40,41].
The pathogenesis of analgesic nephropathy operates via a dual-pathway injury cascade combining microvascular hemodynamic ischemia and direct metabolite-mediated cellular cytotoxicity [42,43]. This localized toxic concentration selectively destroys the renal medulla and papillae, generating the hallmark lesions of renal papillary necrosis (RPN) and secondary chronic tubulointerstitial nephritis (CIN) [44,45].
3.1 Prostaglandin Blockade and Renal Medullary Ischemia
Renal vasodilatory prostaglandins—principally PGE2 and PGI2—are produced in renal cortical and medullary tissues via cyclooxygenase enzymes COX-1 and COX-2 [46,47]. PGE2 and PGI2 maintain afferent arteriolar dilatation and sustain microvascular blood flow through the medullary vasa recta [48]. The inner renal medulla naturally exists in a state of borderline hypoxia, with tissue oxygen tension (pO2) ranging between 10 and 20 mmHg despite high total renal blood flow [49,50]. Inhibition of COX-1 and COX-2 by NSAIDs abolishes protective prostaglandin synthesis, producing intense vasoganglion constriction in the vasa recta [51,52]. Medullary hypoperfusion impairs oxygen delivery to high-metabolic energy-demanding tubular segments, specifically the thick ascending limb of Henle's loop and medullary collecting ducts [53]. Ischemic endothelial damage induces microvascular thrombosis, capillary loss, and severe ischemic tissue necrosis at the papillary tip [54].
3.2 Acetaminophen Bioactivation and Direct Oxidative Cytotoxicity
While NSAIDs induce vasoganglion ischemia, acetaminophen exerts direct biochemical toxicity within medullary cells [55,56]. In the renal medulla, acetaminophen undergoes bioactivation by cytochrome P450 enzymes (CYP2E1) and prostaglandin H synthase into N-acetyl-p-benzoquinone imine (NAPQI), an electrophilic reactive intermediate [57,58]. Under high cumulative exposures, NAPQI exhausts medullary glutathione (GSH) antioxidant stores [59]. Depletion of glutathione enables NAPQI to bind covalently to intracellular renal proteins, damaging mitochondrial respiratory chains, inducing lipid peroxidation, and generating abundant reactive oxygen species (ROS) [60,61]. This cellular oxidative stress is concentrated by the renal countercurrent multiplication system, which concentrates acetaminophen and its metabolites up to 20-fold higher in the inner medulla than in systemic circulation [62,63].
3.3 Progression from Papillary Necrosis to Chronic Interstitial Nephritis
The interaction between NSAID-induced medullary ischemia and acetaminophen-induced oxidative toxicity leads to necrosis of the renal papillae [64,65]. Papillary tips undergo patchy, focal necrosis that coalesces into confluent renal papillary necrosis (RPN) [66]. Necrotic papillae may detach into the pelvicalyceal system, potentially causing ureteral colic or obstructive uropathy [67]. Following papillary destruction, retrograde degeneration of overlying nephrons occurs [68,69]. Obstruction of collecting tubules causes upstream cortical tubular atrophy, loss of peritubular capillaries, and an extensive inflammatory infiltrate composed of T lymphocytes, macrophages, and plasma cells [70,71]. Pro-fibrotic cytokines, including transforming growth factor-beta 1 (TGF-β1), drive interstitial fibroblast activation and collagen deposition [72]. Over months to years, this process transforms focal papillary lesions into diffuse chronic tubulointerstitial nephritis (CIN) with secondary glomerulosclerosis, driving progressive loss of GFR [73,74].
Analgesic nephropathy is clinically insidious, often remaining asymptomatic until advanced CKD (Stage 4 or 5) develops [75]. Early functional deficits reflect medullary damage, including impaired urinary concentrating ability (isosthenuria, nocturia), Type 4 renal tubular acidosis, and urinary sodium wasting [76,77]. Urinalysis typically reveals a 'bland' sediment, mild non-nephrotic proteinuria (<1.0 g/day), and sterile pyuria (leukocyturia without urinary tract infection) [78,79].
4.1 Diagnostic Imaging Criteria on Non-Contrast CT
Non-contrast computed tomography (NCCT) is the imaging modality of choice for confirming analgesic nephropathy [80,81]. The pathognomonic NCCT triad consists of: (1) bilaterally decreased renal volume; (2) bumpy or wavy renal contours caused by cortical scar depressions overlying necrotic papillae; and (3) calcified renal papillae [82,83]. In individuals with a verified history of long-term analgesic abuse, this NCCT triad demonstrates a sensitivity of 87% and specificity exceeding 95% [84].
4.2 Biomarkers and Urothelial Malignancy Risk
Novel tubular injury biomarkers, including Kidney Injury Molecule-1 (KIM-1), Neutrophil Gelatinase-Associated Lipocalin (NGAL), and N-acetyl-β-D-glucosaminidase (NAG), allow detection of active tubulointerstitial stress prior to overt serum creatinine elevations [85,86]. A well-established late complication of chronic AN is an increased risk of urothelial carcinoma (transitional cell carcinoma) of the renal pelvis, ureter, or bladder, mediated by chronic carcinogenic metabolite exposure [87,88]. Internists must promptly evaluate unexplained hematuria or flank pain in AN patients with urine cytology and urological imaging [89].
Hospital admission presents both a risk and an opportunity for patients with analgesic nephropathy [90]. Acute intercurrent illness, dehydration, diagnostic contrast media, and inpatient drug prescriptions can aggravate baseline kidney injury [91]. A structured, ward-based approach enables internists to identify AN early, prevent iatrogenic AKI, and initiate safe inpatient pain control.
5.1 Targeted Inpatient Admission Medication Reconciliation
Routine admission medication records often fail to capture over-the-counter pain medications [92]. Internists should implement a structured analgesic history for all patients admitted with unexplained CKD, sterile pyuria, or high-risk profiles [93]. Clinicians should specifically ask about brand-name OTC remedies, multi-ingredient cold/flu medications, topical formulations, and daily tablet consumption counts to calculate estimated lifetime cumulative analgesic exposure [94].
5.2 Autoregulation Protection and De-prescribing Protocols
When AN or active analgesic abuse is identified, all NSAIDs (including COX-2 inhibitors) and nephrotoxic combination products must be immediately discontinued [95]. During acute ward stays involving volume depletion, sepsis, or acute intercurrent illness, internists should temporarily hold RAAS inhibitors and diuretics to preserve renal autoregulation and avoid 'triple whammy' hemodynamic failure [96,97].
5.3 Inpatient Multimodal Pain Management
Stopping habituated analgesics without substituting effective alternative pain control leads to poor patient satisfaction and non-compliance [98]. Internists should utilize a nephro-protective multimodal analgesia strategy [99]. Acetaminophen at reduced total daily doses (≤2.0 g/day in divided doses) can be safely utilized for mild pain in patients without hepatic impairment [100]. Neuropathic or somatic pain may be managed with dose-adjusted gabapentinoids, topical lidocaine 5% patches, or short-term low-dose atypical opioids (e.g., buprenorphine or tramadol adjusted for eGFR) alongside early physical therapy consultation [101,102].
Preventing analgesic nephropathy requires coordinated action spanning clinical de-prescribing, patient health literacy education, and health system quality controls [103]. Complete cessation of offending analgesics is the paramount factor governing kidney outcomes; clinical studies confirm that early drug discontinuation leads to stabilization or improvement in eGFR in up to 60% of patients with mild-to-moderate CIN [104,105].
6.1 Patient Education and Discharge Counseling
Discharge counseling must explicitly challenge the pervasive belief that over-the-counter pain relievers are harmless [106]. Internists should inform patients that OTC status does not guarantee renal safety, particularly when taken daily or in combination [107]. Patients should be taught to read product packaging labels to avoid accidental double-dosing of acetaminophen or NSAIDs contained in multi-ingredient cold and flu remedies [108]. Providing a written 'Nephro-Protective Discharge Care Plan' ensures primary care physicians and outpatient pharmacists reinforce these safety parameters [109].
6.2 Health System and Regulatory Safeguards
At the health system level, electronic health record (EHR) clinical decision support systems (CDSS) serve as vital safeguards [110]. Automated EHR alerts that flag NSAID orders in patients with baseline eGFR <60 mL/min/1.73m² or trigger warnings during concurrent 'triple whammy' prescriptions significantly lower inappropriate inpatient drug exposure [111,112]. Furthermore, public health policies restricting over-the-counter pack sizes of combination analgesics and mandating prominent kidney warning labels on packaging remain highly effective population-level strategies [113,114].
Analgesic nephropathy in 2026 represents a major, preventable cause of chronic kidney disease and acute-on-chronic renal breakdown. The shift from phenacetin to widespread self-administration of NSAID and acetaminophen combinations has obscured its recognition without reducing its nephrotoxic potential. Understanding the dual pathophysiological pathways—prostaglandin-mediated medullary vasoganglion ischemia and metabolite-driven oxidative cytotoxicity—allows general internists to interpret early diagnostic markers on non-contrast CT and novel tubular biomarkers. By executing structured admission medication reconciliation, preventing 'triple whammy' hemodynamic collapse, establishing safe inpatient multimodal pain pathways, and delivering clear patient discharge counseling, internists can preserve functional nephrons and halt the trajectory toward end-stage kidney disease.
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I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
