Rhabdomyolysis and Acute Kidney Injury Requiring Dialysis as a Result of Concomitant Use of Atypical Neuroleptics and Synthetic Cannabinoids

Zhao, Aiyu; Tan, Maybel; Maung, Aung; Salifu, Moro O.; Mallappallil, Mary

doi:10.1155/2015/235982

Cited by 24 publications

(17 citation statements)

References 18 publications

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“…They are becoming more popular due to the high potency that is achieved when smoked but also to their difficulty in being detected in a urine drug screen [21]. There have been several reports connecting synthetic marijuana to AKI in the form of acute tubular necrosis [22] and/or rhabdomyolysis [23][24][25]. It is also possible that the synthetic cannabinoids acted as a ''second hit'' for his genetic disease to manifest clinically.…”

Section: Discussionmentioning

confidence: 99%

McArdle disease: a “pediatric” disorder presenting in an adult with acute kidney injury

Zhao

Soni

et al. 2017

CEN Case Rep

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Rhabdomyolysis is characterized by the acute breakdown of skeletal muscle, resulting in the release of muscle cell contents, subsequent myoglobinuria, and in severe cases, acute renal failure. A number of etiologies have been identified in acute rhabdomyolysis, in which drugs and trauma account for the majority of cases. One etiological category that is commonly overlooked in the adult population is an underlying genetic defect. This may be challenging to diagnose due to its rarity in the adult demographic and the marked heterogeneity, often requiring a high level of clinical suspicion before investigation is pursued. Once diagnosed, however, appropriate steps can be taken to reduce future episodes of rhabdomyolysis, further renal injury, and other systemic complications. Here, we report a case of an adult patient presenting with acute rhabdomyolysis secondary to McArdle disease, a genetic disease causing defective glycogenolysis. The case highlights the importance of recognizing the potential of undiagnosed ''pediatric'' disorders in adulthood and particularly for underlying genetic causes of rhabdomyolysis.

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Section: Discussionmentioning

confidence: 99%

McArdle disease: a “pediatric” disorder presenting in an adult with acute kidney injury

Zhao

Soni

et al. 2017

CEN Case Rep

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“…In their case, Zhao et al (6), started dialysis to the patient with two positive edema, and with a level of serum CK of 148000/L; potassium 6.9 mmol/L, and Cr 7.5 mg/dL on the third day of hospitalization. They made a total of 10 dialysis sessions.…”

Section: Discussionmentioning

confidence: 99%

“…Besides, unconsciousness, agitation, non-pitting edema was observed in legs, rubescence, widespread body pain and facial trismus appearance were observable. 6. Since the drug panel THC in his blood and urine was positive, the patient was admitted to the intensive care unit for further treatment.…”

Section: Case Reportmentioning

confidence: 99%

Rhabdomyolysis and Renal Insufficiency Due to Synthetic Cannabinoid Intoxication

Orhan¹,

Gülsoy²,

Demirel³

et al. 2017

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“…Opioids can lead to a decrease in fluid intake resulting in dehydration. Opioids also increase vagal activity as well as parasympathetic stimulation resulting in decreased cardiac ionotropy, bradycardia and hypotension [8][9][10][11]. Dehydration and hypotension act in concert to induce renal hypoperfusion and hence intra-renal vasoconstriction.…”

Section: Discussionmentioning

confidence: 99%

“…Cardiopulmonary demise is a major cause of death in heroin overdose; however, acute kidney injury (AKI) is emerging as a major contributor [5,6,[8][9][10][11]. It has been documented that the development of AKI is associated with a fourfold increase in death and that its timely diagnosis and treatment improves mortality [12].…”

Section: Introductionmentioning

confidence: 99%

Heroin Epidemic and Acute Kidney Injury: An Under-Recognized but Important Consequence of Opioid Overdose

et al. 2017

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Heroin abuse and overdose are increasing at an alarming rate in the United States. Due to its relatively low cost and ease of availability, over a million people are abusing this agent. What is most disturbing is the fact that heroin-associated deaths have tripled over the past 5 years. While heroin has a major negative impact on the cardiopulmonary system, acute kidney injury (AKI) following heroin overdose is emerging as a major problem. AKI increases mortality and is a major cause of the development of chronic kidney disease and its antecedent long-term mortality. Timely diagnosis of AKI and its treatment reduces mortality. In this article, we present two cases (a 25-year-old man and a 22-year-old woman) of heroin-induced AKI. Both presented with altered mental status, respiratory depression and low blood pressure. AKI was diagnosed by the treating internist in a timely fashion and optimally treated in the 25-year-old man. In the 22-year-old woman who presented to the emergency department, AKI could not be recognized. She was discharged home after the management of overdose with resolution of pulmonary and neurological issues. Six days later, she returned to the emergency department with shortness of breath, volume overload, and severe acute tubular necrosis, required hemodialysis and left the hospital with serum creatinine of 2.5 mg/ dL (estimated glomerular filtration rate (eGFR) = 46 mL/min). At a 7-month follow-up, this patient continues to have eGFR of 45 mL/min (stage III chronic kidney disease). This article presents the mechanism of heroin-induced AKI as well as its management strategy and calls for heightened awareness for early diagnosis and prompt treatment.

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Rhabdomyolysis and Acute Kidney Injury Requiring Dialysis as a Result of Concomitant Use of Atypical Neuroleptics and Synthetic Cannabinoids

Cited by 24 publications

References 18 publications

McArdle disease: a “pediatric” disorder presenting in an adult with acute kidney injury

McArdle disease: a “pediatric” disorder presenting in an adult with acute kidney injury

Rhabdomyolysis and Renal Insufficiency Due to Synthetic Cannabinoid Intoxication

Heroin Epidemic and Acute Kidney Injury: An Under-Recognized but Important Consequence of Opioid Overdose

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