Cocaine and kidney injury: A kaleidoscope of pathology

Research output: Contribution to journalReview article

15 Citations (Scopus)

Abstract

Cocaine is abused worldwide as a recreational drug. It is a potent activator of the sympathetic nervous system leading to intense vasoconstriction, endothelial dysfunction, oxidative stress, platelet activation and decrease in prostaglandins E2 and prostacyclin. Cocaine can lead to widespread systemic adverse effects such as stroke, myocardial infarction, arterial dissection, vascular thrombosis and rhabdomyolysis. In human and rat kidneys, cocaine has been associated with glomerular, tubular, vascular and interstitial injury. It is not uncommon to diagnose cocainerelated acute kidney injury (AKI), malignant hypertension and chronic kidney disease. Cocaine abuse can lead to AKI by rhabdomyolysis, vasculitis, infarction, thrombotic microangiopathy and malignant hypertension. It is reported that 50-60% of people who use both cocaine and heroin are at increased risk of HIV, hepatitis and additional risk factors that can cause kidney diseases. While acute interstitial nephritis (AIN) is a known cause of AKI, an association of AIN with cocaine is unusual and seldom reported. We describe a patient with diabetes mellitus, hypertension and chronic hepatitis C, who presented with AKI. Urine toxicology was positive for cocaine and a kidney biopsy was consistent with AIN. Illicit drugs such as cocaine or contaminants may have caused AIN in this case and should be considered in the differential diagnosis of causes of AKI in a patient with substance abuse. We review the many ways that cocaine adversely impacts on kidney function.

Original languageEnglish (US)
Pages (from-to)513-517
Number of pages5
JournalClinical Kidney Journal
Volume7
Issue number6
DOIs
StatePublished - Dec 1 2014

Fingerprint

Cocaine
Pathology
Kidney
Interstitial Nephritis
Acute Kidney Injury
Wounds and Injuries
Malignant Hypertension
Rhabdomyolysis
Street Drugs
Thrombotic Microangiopathies
Cocaine-Related Disorders
Vascular System Injuries
Heroin
Sympathetic Nervous System
Platelet Activation
Kidney Diseases
Epoprostenol
Chronic Hepatitis C
Vasculitis
Vasoconstriction

Keywords

  • AIN
  • AKI
  • Cocaine
  • Vasoconstriction

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Cocaine and kidney injury : A kaleidoscope of pathology. / Goel, Narender; Pullman, James M.; Coco, Maria.

In: Clinical Kidney Journal, Vol. 7, No. 6, 01.12.2014, p. 513-517.

Research output: Contribution to journalReview article

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