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

Mansoor, Kanaan; Kheetan, Murad; Shahnawaz, Saba; Shapiro, Anna P.; Patton-Tackett, Eva; Dial, Larry; Rankin, Gary O.; Santhanam, Prasanna; Tzamaloukas, Antonios H.; Nádasdy, Tibor; Shapiro, Joseph I.; Khitan, Zeid

doi:10.1186/s12882-017-0794-0

Cited by 35 publications

(33 citation statements)

References 128 publications

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“…30 The use of illicit substances such as cocaine, heroin, or methamphetamine has also been linked with an increased risk for CKD progression and increased mortality risk among adults with established CKD. 105,106 Infections such as endocarditis, hepatitis B and C, and HIV also increase the risk factors for CKD. 10 Furthermore, heavy metal pollutants (e.g., arsenic, cadmium, lead, and mercury) and other environmental toxins have been shown to be harmful to the kidneys.…”

Section: Mitigation Of Nontraditional Risk Factors For Ckdmentioning

confidence: 99%

Preventing CKD in Developed Countries

Luyckx

Cherney

Bello

2020

Kidney International Reports

108

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Chronic kidney disease (CKD) is an important public health concern in developed countries because of both the number of people affected and the high cost of care when prevention strategies are not effectively implemented. Prevention should start at the governance level with the institution of multisectoral polices supporting sustainable development goals and ensuring safe and healthy environments. Primordial prevention of CKD can be achieved through implementation of measures to ensure healthy fetal (kidney) development. Public health strategies to prevent diabetes, hypertension, and obesity as risk factors for CKD are important. These approaches are cost-effective and reduce the overall noncommunicable disease burden. Strategies to prevent nontraditional CKD risk factors, including nephrotoxin exposure, kidney stones, infections, environmental exposures, and acute kidney injury (AKI), need to be tailored to local needs and epidemiology. Early diagnosis and treatment of CKD risk factors such as diabetes, obesity, and hypertension are key for primary prevention of CKD. CKD tends to occur more frequently and to progress more rapidly among indigenous, minority, and socioeconomically disadvantaged populations. Special attention is required to meet the CKD prevention needs of these populations. Effective secondary prevention of CKD relies on screening of individuals at risk to detect and treat CKD early, using established and emerging strategies. Within high-income countries, barriers to accessing effective CKD therapies must be recognized, and public health strategies must be developed to overcome these obstacles, including training and support at the primary care level to identify individuals at risk of CKD, and appropriately implement clinical practice guidelines.

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Section: Mitigation Of Nontraditional Risk Factors For Ckdmentioning

confidence: 99%

Preventing CKD in Developed Countries

Luyckx

Cherney

Bello

2020

Kidney International Reports

108

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“…In a systematic review of nephrotoxicities related to drugs of abuse, cocaine use was associated with an elevated risk of rhabdomyolysis and ischemic nephropathy. 26 Ongoing monitoring of renal function as recommended by PrEP clinical guidelines is warranted, but more intensive renal monitoring with concomitant stimulant use does not seem indicated.…”

Section: Discussionmentioning

confidence: 99%

“…Cocaine use is associated with glomerular, tubular, vascular, and interstitial damage, and can precipitate acute kidney injury. [23][24][25][26] To address these gaps in the literature, we assessed the associations of biologically confirmed cocaine use with PrEP adherence (assessed objectively via a pharmacologic measure), PrEP care engagement, and renal function in the iPrEx open label extension (OLE).…”

Section: Introductionmentioning

confidence: 99%

Brief Report: Cocaine Use and Pre-exposure Prophylaxis: Adherence, Care Engagement, and Kidney Function

Hojilla

Satre

Glidden

et al. 2019

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Concomitant use of cocaine and HIV pre-exposure prophylaxis (PrEP) raises important clinical questions around adherence, retention in care, and renal toxicity. Methods: We assessed the associations of confirmed cocaine use with PrEP adherence (both ascertained via objective measures), care engagement, and renal function in the iPrEx open label extension. Cocaine use was measured in scalp hair samples and categorized as: light (500-3,000 pg/mg) and moderate to heavy (>3,000 pg/mg). PrEP adherence in the first three months was measured via plasma tenofovir concentrations. Disengagement from PrEP care was defined as a gap in follow-up greater than four months. Serum creatinine was assessed at baseline and quarterly visits. Results: Of the 400 participants included in this analysis, 90% were men who have sex with men, 10% transgender women, 74% Hispanic/Latino; 21% tested positive for cocaine use in the last three months. In adjusted analysis, light cocaine use (aOR 2.10 [95% CI 1.07-4.14]) and moderate to heavy use (aOR 2.32 [1.08-5.00]) were associated with greater odds of having plasma tenofovir concentrations below the level of quantitation. Participants with moderate to heavy use

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“…Two recent reviews of nephrotoxicity from illicit drugs have found some evidence of direct nephrotoxicity. Where kidney biopsies have been available, renal injury other than acute tubular necrosis have included acute interstitial nephritis and glomerulonephritis as the commonest, but other findings include thrombotic microangiopathy (MDMA), vasculitis (MDMA, cocaine), vascular thrombosis or infarction (cocaine), and crystal nephropathy (heroin, cannabinoids) . The additional mechanisms of renal injury may explain why illicit drug users develop worse AKI even allowing for their higher CK.…”

Section: Discussionmentioning

confidence: 99%

Illicit drug use and acute kidney injury in patients admitted to hospital with rhabdomyolysis

Yim

Wong

Jellie

et al. 2019

Internal Medicine Journal

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Background Severe rhabdomyolysis is associated with acute kidney injury, but it is unclear if patients developing rhabdomyolysis after illicit drug use have a higher risk of acute kidney injury compared to other causes. Aims To provide a descriptive analysis of patients admitted with rhabdomyolysis, with a focus on illicit drug use, and to determine if illicit drug use was an independent predictor for acute kidney injury or renal replacement therapy. Methods We conducted a 5‐year cohort study of patients admitted to Monash Health, a tertiary referral hospital network. We identified adult patients with muscle injury from ICD‐10 AM codes, serum creatine kinase level greater than 1000 U/mL, and a clinical history consistent with rhabdomyolysis. We determined the prevalence and type of illicit drug involved and determined the association between illicit drug use and renal outcomes by logistic regression. Results Of 643 patients, illicit drug use was identified in 12%. Acute kidney injury developed in 51%, and 5% required renal replacement therapy. Compared to the rest of the cohort, patients who used illicit drugs were younger and had higher peak serum creatine kinase, and developed a higher severity of acute kidney injury. In multivariable analysis, the factors associated with acute kidney injury were illicit drug use, peak creatine kinase, cardiovascular disease, concurrent sepsis and a clinically‐evident pressure injury. Chronic kidney disease and need for fasciotomy were additional risk factors for renal replacement therapy. Conclusions Illicit drug use was associated with acute kidney injury and renal replacement therapy independent of creatine kinase levels.

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

Cited by 35 publications

References 128 publications

Preventing CKD in Developed Countries

Preventing CKD in Developed Countries

Brief Report: Cocaine Use and Pre-exposure Prophylaxis: Adherence, Care Engagement, and Kidney Function

Illicit drug use and acute kidney injury in patients admitted to hospital with rhabdomyolysis

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