Multiorgan Dysfunction Related to Chronic Ketamine Abuse

Pappachan, Joseph M; Raj, Binu; Thomas, S.; Hanna, Fahmy

doi:10.1080/08998280.2014.11929117

Cited by 21 publications

(16 citation statements)

References 8 publications

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“…Urine cultures were typically negative as in our present series, although an occasional contaminated growth or sterile pyuria may be present . Impaired renal function is associated with chronic misuse and deranged liver function tests are not uncommon due to ketamine‐induced hepatic dysfunction .…”

Section: Discussionsupporting

confidence: 54%

The effects of recreational ketamine cystitis on urinary tract reconstruction – a surgical challenge

2018

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In a tertiary high-volume reconstructive unit, ketamine patients were at high risk of significant perioperative complications. There did not appear to be any other common factor apart from their use of ketamine, and the significant inflammatory change associated with this. We recommend meticulous preoperative evaluation and multidisciplinary consultation for all patients to determine optimal treatment strategies.

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Section: Discussionsupporting

confidence: 54%

The effects of recreational ketamine cystitis on urinary tract reconstruction – a surgical challenge

2018

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“…urinary bladder; ketamine cystitis; voiding spot assay; umbrella cell; permeability KETAMINE is an anesthetic that is being increasingly used as a recreational drug due to its hallucinatory effects. Ketamine abuse causes chronic toxicity to many organs, including cardiovascular, hepatobiliary, respiratory, gastrointestinal, and lower urinary systems (2,3,11,15,21,26,27,29). At least ϳ30% of ketamine abusers reported the presence of lower urinary tract symptoms, such as severe dysuria, painful hematuria, urinary frequency, urgency, and urge urinary incontinence.…”

mentioning

confidence: 99%

Intact urothelial barrier function in a mouse model of ketamine-induced voiding dysfunction

Rajandram¹,

Ong

Razack

et al. 2016

American Journal of Physiology-Renal Physiology

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Ketamine is a popular choice for young drug abusers. Ketamine abuse causes lower urinary tract symptoms, with the underlying pathophysiology poorly understood. Disruption of urothelial barrier function has been hypothesized to be a major mechanism for ketamine cystitis, yet the direct evidence of impaired urothelial barrier function is still lacking. To address this question, 8-wk-old female C57BL/6J mice were injected intraperitoneally with 30 mg·kg(-1)·day(-1) ketamine for 12 wk to induce ketamine cystitis. A spontaneous voiding spot assay showed that ketamine-treated mice had increased primary voiding spot numbers and smaller primary voiding spot sizes than control mice (P < 0.05), indicating a contracted bladder and bladder overactivity. Consistently, significantly increased voiding frequency was observed in ketamine-treated mice on cystometrograms. These functional experiments indicate that ketamine induces voiding dysfunction in mice. Surprisingly, urothelial permeability in ketamine-treated mice was not changed when measured using an Ussing chamber system with isotopic urea and water. Mouse urothelial structure was also not altered, and intact umbrella cell structure was observed by both transmission and scanning electron microscopy. Furthermore, immunostaining and confocal microscopy confirmed the presence of a well-defined distribution of zonula occuldens-1 in tight junctions and uroplakin in umbrella cells. In conclusion, these data indicate that ketamine injection induces voiding dysfunction in mice but does not necessarily disrupt mouse bladder barrier function. Disruption of urothelial barrier function may not be the major mechanism in ketamine cystitis.

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“…Ainsi, en Asie, la ké tamine est l'une des principales substances dé tourné es. L'utilisation chronique de ké tamine, d'origine pharmaceutique ou de fabrication clandestine, est associé e au dé veloppement de cystites à ré pé tition, d'une incontinence urinaire et de douleurs lombaires chroniques [10].…”

Section: Atteintes Urologiques : Ke´tamine Et Amphe´tamines Et De´riunclassified

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

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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.

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Multiorgan Dysfunction Related to Chronic Ketamine Abuse

Cited by 21 publications

References 8 publications

The effects of recreational ketamine cystitis on urinary tract reconstruction – a surgical challenge

The effects of recreational ketamine cystitis on urinary tract reconstruction – a surgical challenge

Intact urothelial barrier function in a mouse model of ketamine-induced voiding dysfunction

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

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