Methamphetamine intoxication and acute kidney injury: A prospective observational case series

Isoardi, Katherine Z; Mudge, David W.; Harris, Keith; Dimeski, Goce; Buckley, Nicholas A

doi:10.1111/nep.13762

Cited by 17 publications

(15 citation statements)

References 17 publications

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“…Activation of non-shivering thermogenesis in brown adipose tissue and macrophages causes dysregulation of signalling transcription and regulation of thermogenic genes [23,24] and hyperthermia, a potentially lethal side-effect of MA [25]. Vasoconstriction may cause short-lived acute kidney injury [26] and chronic kidney injury with changes consistent with thrombotic microangiopathic injury and advanced glomerulosclerosis have been noted. [27].…”

Section: Ma: Effects On the Pulmonary And Other Systemsmentioning

confidence: 99%

Prenatal methamphetamine—impact on the mother and child—a review

et al. 2021

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Methamphetamine (MA) is the second most commonly used illicit drug in the world, after cannabis. There are limited data on the outcomes of pregnant MA users but there is rapidly emerging evidence to suggest that they are more vulnerable, marginalized and impoverished compared with other drug‐using mothers. MA use during pregnancy is associated with worse pregnancy outcomes and significantly higher rates of co‐existing health and psychosocial problems. Newborn infants exposed to MA are at increased risk of perinatal complications, present differently at birth to infants exposed to other drugs of dependency such as opioids and have poorer neurological adaptation and feeding difficulties. Sparse literature from neuroimaging and cohort studies suggests that the neurocognitive deficits in MA exposed children persist, even into adulthood. Current clinical practice guidelines for the care of substance exposed pregnant women are opioid‐centric with little attention paid to the consequences of prenatal MA exposure.

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Section: Ma: Effects On the Pulmonary And Other Systemsmentioning

confidence: 99%

Prenatal methamphetamine—impact on the mother and child—a review

et al. 2021

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“…In this regard, a post-mortem examination of a 53-year-old man whose death was certified as METH toxicity evinced diverticulum of the duodenum and neutrophilic infiltrate (Sakry and Kemp, 2020). Neutrophil involvement in METH-mediated acute kidney injury, a common condition observed in intoxication, is observed in approximately 10% of the cases (Isoardi et al, 2020). In addition, acute METH administration and LPS challenge stimulate the infiltration of macrophages and neutrophils into the CNS, which may have significant implications in users' neurotoxicity (DiCaro et al, 2019).…”

Section: Granulocytesmentioning

confidence: 99%

Methamphetamine Dysregulation of the Central Nervous System and Peripheral Immunity

Miller

Gopinath

et al. 2021

J Pharmacol Exp Ther

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Methamphetamine (METH) is a potent psychostimulant that increases extracellular monoamines such as dopamine and norepinephrine and affects multiple tissue and cell types in the CNS and peripheral immune cells. The reinforcing properties of METH underlie its significant abuse potential and dysregulation of peripheral immunity and central nervous system functions. Together, the constellation of METH's effects on cellular targets and regulatory processes has led to immune suppression and neurodegeneration in METH addicts and animal models of METH exposure. Here we extensively review many of the cell types and mechanisms of METH-induced dysregulation of the central nervous and peripheral immune systems. Significance StatementEmerging research has begun to show that methamphetamine regulates dopaminergic neuronal activity. In addition, METH affects non-neuronal brain cells, such as microglia and astrocytes, and immunological cells of the periphery. Concurrent disruption of bidirectional communication between dopaminergic neurons and glia in the CNS and peripheral immune cell dysregulation gives rise to a constellation of dysfunctional neuronal, cell, and tissue types. Therefore, understanding the pathophysiology of METH requires consideration of the multiple targets at the interface between basic and clinical neuroscience.

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“…It is important to note that a number of other coexisting causes of rhabdomyolysis may have contributed to this case. The patient had used methamphetamine, an established cause of rhabdomyolysis secondary to vasoconstriction induced muscle ischaemia and prolonged muscle contraction-induced ATP depletion [ 13 – 15 ]. The contribution of methamphetamines is likely limited, however, given the small dose that was administered, to which the patient was tolerant of higher doses, without having previously developed rhabdomyolysis.…”

Section: Discussionmentioning

confidence: 99%

A suspected case of hyponatraemia induced rhabdomyolysis: a case report

2022

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Background Hyponatraemia is a documented but under-recognised cause of rhabdomyolysis, with the contrasting treatment strategies for the two conditions posing a unique challenge. Balancing the need for aggressive fluid replacement for the treatment of rhabdomyolysis, with the risk of rapidly correcting hyponatraemia is imperative. Case presentation A 52-year-old gentleman with a background of HIV infection and hypertension presented with seizures following methamphetamine use, acute water intoxication, and thiazide use. He was found to have severe hyponatraemia, and following initial correction with hypertonic saline, was commenced on a fluid restriction. After two days he developed abdominal wall and thigh pain, along with oliguria. Laboratory data demonstrated markedly elevated creatine kinase levels and deteriorating renal function. A diagnosis of rhabdomyolysis and severe acute kidney injury was made and aggressive fluid replacement commenced, leading to full resolution of the hyponatraemia, rhabdomyolysis and acute kidney injury. Conclusion Hyponatraemia-induced rhabdomyolysis is rare but can cause significant morbidity and mortality if left untreated. Physicians should consider measuring creatine kinase levels in all patients presenting with severe hyponatraemia, particularly in the presence of other risk factors for rhabdomyolysis. Fluid replacement strategies must be considered in relation to the relative onset and risk of over-correcting hyponatraemia.

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Methamphetamine intoxication and acute kidney injury: A prospective observational case series

Cited by 17 publications

References 17 publications

Prenatal methamphetamine—impact on the mother and child—a review

Prenatal methamphetamine—impact on the mother and child—a review

Methamphetamine Dysregulation of the Central Nervous System and Peripheral Immunity

A suspected case of hyponatraemia induced rhabdomyolysis: a case report

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