Heroin crystal nephropathy

Bautista, Josef; Merhi, Basma; Gregory, Oliver; Hu, Susie L.; Henriksen, Kammi J.; Gohh, Reginald

doi:10.1093/ckj/sfv018

Cited by 9 publications

(6 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Meanwhile, a prospective cohort study reported that reduced eGFR was associated with Heroin [ 42 ]. Lastly, a relatively new mode of AKI has come to light as “heroin crystal nephropathy” by Bautista et al in 2015 [ 43 ]. This case showed that volume depletion along with elevated urinary pH leads to crystallization of Heroin or its metabolites in renal tubules.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Systematic review of nephrotoxicity of drugs of abuse, 2005–2016

et al. 2017

View full text Add to dashboard Cite

BackgroundThe United States is faced with an unprecedented epidemic of drug abuse. Every year thousands of Americans visit the emergency departments all over the country with illicit drug related complaints. These drugs have been known to be associated with a range of renal pathologies, from reversible acute kidney injuries to debilitating irreversible conditions like renal infarction. So far, no comprehensive study or systematic review has been published that includes the commonly used street drugs and designer drugs with potential nephrotoxic outcomes.MethodsWe conducted a systematic review of published case reports, case series, and cross sectional studies of nephrotoxicities related to drugs of abuse. Literature review was conducted using PubMed/Medline from January 1, 2005 -December 31, 2016 to search for publications related to drug abuse with a defined renal outcome. Publications which reported renal injury in relation to the use of illicit drugs were selected, specifically those cases with raised creatinine levels, clinically symptomatic patients, for instance those with oliguria and proven renal biopsies.ResultsA total of 4798 publications were reviewed during the search process and PRISMA flow chart and Moose protocol regarding systematic reviews were followed. 110 articles were shortlisted for the review. A total of 169 cases from case reports and case series, and 14 case studies were analyzed. Renal manifestations of specific illicit drug abuse were included in this review.ConclusionBased on the evidence presented, a wide range of renal manifestations were found to be associated with drug abuse. If the trend of increasing use of illicit drug use continues, it will put a significant percentage of the population at an elevated risk for poor renal outcomes. This study is limited by the nature of the literature reviewed being primarily case reports and case series.

show abstract

Section: Discussionmentioning

confidence: 99%

“…This case showed that volume depletion along with elevated urinary pH leads to crystallization of Heroin or its metabolites in renal tubules. Heroin being adulterated with sodium bicarbonate is the likely explanation [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Systematic review of nephrotoxicity of drugs of abuse, 2005–2016

et al. 2017

View full text Add to dashboard Cite

show abstract

“…L'hé roïne, qui peut cristalliser à pH alcalin, peut entraîner des tubulopathies cristallines [21,22].…”

Section: Rhabdomyolyse Et Tubulopathies : Cocaïne He´roïne Amphe´taunclassified

“…Par ailleurs, des glomé ruloné phrites membrano-prolifé ratives (GNMP) ont é té dé crites aprè s consommation de cannabis [49], de cocaïne [50], d'hé roïne [21] et d'amphé tamine [51].…”

Section: Autres Glome´rulopathiesunclassified

Effets uro-néphrologiques des produits utilisés par les usagers de drogues : revue de la littérature et enquête pharmaco-épidémiologique en France et dans la région de Marseille

Gully

Frauger²,

Spadari³

et al. 2017

Néphrologie & Thérapeutique

View full text Add to dashboard Cite

A great diversification of drugs of abuse has been observed in recent years, both in the populations using them and in the types of drugs. Although dependency and psychiatric disorders associated with the abuse of these substances is well known, somatic complications, uro-nephrotoxicity in particular, are less recognized. We propose here an overview of the products used by drugs abusers in France, through the analysis of the national pharmaco-epidemiological study Observation des produits psychotropes illicites ou détournés de leur utilisation médicamenteuse (OPPIDUM). Among the 5003 patients who participated in this survey, 84% were on prescribed psychoactive substances, with indicators of abuse in 28% of cases; more than half of these patients had also been using drugs of abuse (mainly cannabis) in the previous week. We then describe the main urological and renal toxicities of these drugs, in particular of heroin, cocaine, cannabis, ecstasy, LSD, amphetamine, new designer drugs, ketamine and opiate substitution treatment. We finally present a pharmaco-epidemiological survey of patients hospitalized for drugs complications in nephrology at the university hospital of Marseille. Between 2000 and 2015, 22 patients aged 18 to 57 years were hospitalized for renal adverse effects of drugs of abuse, such as glomerulonephritides, focal segmental glomerulosclerosis, acute kidney injury or chronic kidney disease. The somatic complications of drugs participate in their dangerousness and should be a red flag. They should be systematically reported to the addictovigilance national network to allow the improvement of information given to the patients and the medical community, and to adapt the prevention and risk reduction policies.

show abstract

“…This is most likely due to a hypersensitivity response to adulterants in the heroin preparations, including nonsteroidal anti-inflammatory drugs. Finally, heroin crystal nephropathy has been described recently in the setting of heavy heroin use, and it is likely to occur in the setting of acute tubular injury (6). It is characterized by tubular accumulation of finely granular to fluffy basophilic crystals on light microscopy; the crystals appear as broomstick crystals on urinalysis.…”

mentioning

confidence: 99%

The Changing Spectrum of Heroin-Associated Kidney Disease

Sethi¹

2018

CJASN

View full text Add to dashboard Cite

Heroin crystal nephropathy

Cited by 9 publications

References 29 publications

Systematic review of nephrotoxicity of drugs of abuse, 2005–2016

Systematic review of nephrotoxicity of drugs of abuse, 2005–2016

Effets uro-néphrologiques des produits utilisés par les usagers de drogues : revue de la littérature et enquête pharmaco-épidémiologique en France et dans la région de Marseille

The Changing Spectrum of Heroin-Associated Kidney Disease

Contact Info

Product

Resources

About