Background
Methods
Search strategy
Study inclusion criteria
Results
# of Patients In Case Reports | 47 | 11 | 35 | 16 | 22 | 15 | 23 |
Sex (M:F) | 45:2 (n = 47) | 10:1 (n = 11) | 33:2 (n = 35) | 12:4 (n = 16) | 21:1 (n = 22) | 7:8 (n = 15) | 2:1 (n = 21) |
Age Range (Years) | 15–65 (n = 46) | 25–45 (n = 10) | 24–42 (n = 35) | 2–37 (n = 16) | 22–65 (n = 22) | 22–63 (n = 15) | 22–59 (n = 21) |
Vitals | |||||||
Mean Systolic BP(mm/Hg) | 140.9 (n = 21) | 135.5 (n = 6) | 109.8 (n = 5) | 116.1 (n = 8) | 170.7 (n = 17) | 122 (n = 3) | 110.3 (n = 3) |
Mean Diastolic BP (mm/Hg) | 78.3 (n = 21) | 69.3 (n = 6) | 68.2 (n = 5) | 71.5 (n = 7) | 98.2 (n = 17) | 73 (n = 3) | 59.3 (n = 3) |
Mean Pulse (bpm) | 91.7 (n = 11) | 131.3(n = 8) | 99.75 (n = 4) | 161.1 (n = 14) | 82.5 (n = 11) | 96 (n = 3) | 124 (n = 3) |
Route of Administration | |||||||
Smoking | 29.8% (n = 14) | 0 | 2.9% (n = 1) | 0 | 59.1% (n = 13) | 66.7% (n = 10) | 0 |
Intranasal | 0 | 18.2% (n = 2) | 2.9% (n = 1) | 0 | 18.2% (n = 4) | 20.0% (n = 3) | 0 |
Oral | 14.9% (n = 7) | 27.3% (n = 3) | 0 | 87.5% (n = 14) | 0 | 0 | 26.1% (n = 6) |
Intravenous | 0 | 27.3% (n = 3) | 88.6% (n = 31) | 6.25% (n = 1) | 4.5% (n = 1) | 6.7% (n = 1) | 73.9% (n = 17) |
Not Specified | 55.3% (n = 26) | 27.3% (n = 3) | 5.7% (n = 2) | 6.25% (n = 1) | 18.2% (n = 4) | 6.7% (n = 1) | 0 |
Clinical Presentation* | |||||||
Gastro-intestinal Symptoms | 63.8% (n = 30) | 9.1% (n = 1) | 2.9% (n = 1) | 6.25% (n = 1) | 40.9% (n = 9) | 26.7% (n = 4) | 26.1% (n = 6) |
Altered Mental Status | 25.5% (n = 12) | 36.4% (n = 4) | 8.6% (n = 3) | 31.25% (n = 5) | 4.8% (n = 1) | 6.7% (n = 1) | 17.3% (n = 4) |
Flank Pain | 23.4% (n = 11) | 0 | 0 | 0 | 27.3% (n = 6) | 0 | 0 |
Neuro-Muscular Symptoms | 6.4% (n = 3) | 9.1% (n = 1) | 2.9% (n = 1) | 0 | 0 | 0 | 13.0% (n = 3) |
Hyperthermia | 2.1% (n = 1) | 36.4% (n = 4) | 2.9% (n = 1) | 75% (n = 12) | 13.6% (n = 3) | 6.67% (n = 1) | 0 |
Seizures | 2.1% (n = 1) | 0 | 0 | 56.3% (n = 9) | 0 | 0 | 0 |
Other** | 2.1% (n = 1) | 63.6% (n = 7) | 11.4% (n = 4) | 12.5% (n = 2) | 68.1% (n = 15) | 80.0% (n = 12) | 21.7% (n = 5) |
Lab Parameters | |||||||
Mean Peak Serum Cr (mg/dL) | 7.6 (n = 43) | 7.25 (n = 11) | 2.54 (n = 35) | 3.31 (n = 16) | 7.35 (n = 20) | 6.9 (n = 14) | 4.21 (n = 23) |
Range Peak Serum Cr (mg/dL) | 2.6–21 (n = 43) | 1.2–15.2 (n = 11) | 0.8–11.26 (n = 35) | 1.79–9.60 (n = 16) | 1.3–17.3 (n = 20) | 2–20.8 (n = 14) | 1–14 (n = 23) |
Range Peak Serum CPK (U/L) | 144–301,901 (n = 14) | 1183–235,377 (n = 10) | 3200–236,000 (n = 3) | 863–196,000 (n = 14) | 45–990,400 (n = 13) | 4585 (n = 1) | 17,680–86,000 (n = 4) |
# of cases of ADAMTS%T Def. | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Serology- ANCA | 0 | 0 | 0 | 0 | 0 | 73.3% (n = 11) | 0 |
# of cases with Urinalysis | |||||||
Hematuria | 34.4% (n = 11)+ | 80% (n = 4)B | 61.8% (n = 21)C | 100% (n = 3)E | 75.0% (n = 12) G | 84.6% (n = 11) H | 100% (n = 4)K |
Proteinuria | 68.8% (n = 22)+ | 40% (n = 2) B | 94.1% (n = 32) C | 100% (n = 3) E | 56.25% (n = 9) G | 76.9% (n = 10) H | 75% (n = 3) K |
Eosinophils | 12.5% (n = 4)+ | 0 | 0 | 0 | 6.3% (n = 1) G | 7.7% (n = 1) H | 0 |
Radiology (U/S, CT Scans) | |||||||
Abnormal | 45.9% (n = 17) A | 66.7% (n = 4)U | 75% (n = 3)D | 0% (n = 0)F | 92.8% (n = 13)S | 25% (n- = 1)J | 33.3% (n = 1) L |
Kidney Biopsy | |||||||
Done | 38.3% (n = 18) | 0 | 88.6% (n = 31) | 6.25% (n = 1) | 54.5% (n = 12) | 86.7% (n = 13) | 17.4% (n = 4) |
Renal Biopsy Diagnosis | |||||||
Acute Tubular Necrosis | 55.6% (n = 10) | 0 | 0 | 0 | 0 | 0 | 0 |
Acute/Chronic Interstitial Nephritis | 33.3% (n = 6) | 0 | 9.7% (n = 3) | 0 | 33.3% (n = 4) | 7.7% (n = 1) | 0 |
MPGN | 0 | 0 | 41.9% (n = 13) | 0 | 0 | 0 | 0 |
Thrombotic Microangiopathy | 0 | 0 | 0 | 0 | 25.0% (n = 3) | 7.7% (n = 1) | 100% (n = 4) |
Pauci Immune GN | 0 | 0 | 0 | 0 | 0 | 76.9% (n = 10) | 0 |
Chronic / Hypertensive | 5.6% (n = 1) | 0 | 0 | 0 | 16.7% (n = 2) | 0 | 0 |
Renal Infraction | 0 | 0 | 0 | 0 | 8.3% (n = 1) | 0 | 0 |
Thrombosis | 0 | 0 | 0 | 100% (n = 1) | 8.3% (n = 1) | 0 | 0 |
Crystals | 5.6 (n = 1)[22]M | 0 | 3.3% (n = 1)[43]N | 0 | 0 | 0 | 0 |
Amyloidosis | 0 | 0 | 32.3% (n = 10) | 0 | 0 | 0 | 0 |
Others | 0 | 0 | 12.9% (n = 4)T | 0 | 8.3% (n = 1)[127]P | 7.7% (n = 1)[132]R | 0 |
Diagnosis of non-biopsy Pts. | |||||||
Acute Kidney Injury | 29 | 11 | 4 | 14 | 5 | 2 | 19 |
RPGNs | 0 | 0 | 0 | 1 | 0 | 0 | 0 |
Renal Infraction | 0 | 0 | 0 | 0 | 5 | 0 | 0 |
# of Patients Dialyzed | 23.4% (n = 11) | 27.3% (n = 3) | 11.4% (n = 4) | 40% (n = 6) | 40.9% (n = 9) | 40.0% (n = 6) | 17.4% (n = 4) |
Death as end point | 4.25% (n = 2) | 9.1% (n = 1) | 14.3% (n = 5) | 68.8% (n = 11) | 0 | 6.7% (n = 1) | 17.4% (n = 4) |
Author, Year | Type of Study | Results | Misc Findings |
---|---|---|---|
Synthetic Cannabinoids | |||
Reiderer et al., CDC, 2016 [138] n = 456 | Cross Sectional | Cases involving Synthetic Cannabinoid Use = 456 Sole agent =277; SCB as agent in multi-agent = 179; AKI in Sole agent SCB = 4.0%; Rhabdomyolysis in Sole agent SCB = 6.1% | N/A |
Heroin | |||
Connolly et al., 2006 [36] n = 20 | Cross Sectional | Amyloidosis = 100% Nephrotic Syndrome = 95% ESRD = 60% | Cr mean = 6.4 ± 4.2 mg/dl Proteinuria mean = 7.3 ± 4.1 g/24 h CRP** mean (μmol/l) = 61.4 ± 64 |
Garg et al., 2011 [41], n = 367 | Prospective Cohort Study+ | Heroin use- HR 1.18 (0.75, 1.87) p = 0.43* Model 2- Heroin −1.62 (1.01, 2.60) p = 0.045** Model 4- Heroin- 1.28 (1.07, 2.87) p = 0.352** Model 5- Heroin- 0.97 (0.53, 3.71) p = 0.910** | 216 HIV+ HCV Confection cases 151 HCV Monoinfection cases |
Kosmadakis et al., 2011 [139] n = 21 | Case Control Case =11, Control = 10 | Heroin Users (HU) with Rhabdomyolysis = 11 Non-Heroin Users(NHU) with Rhabdomyolysis =10 Rhabdomyolysis Severity HU > NHU | HU v/s NHU CPK# = p 0.039 HU v/s NHU LDHZ = p 0.031 HU v/s NHU PO4 = p 0.002 |
Novick et al., 2016 [42] n = 2286 | Cohort Study | Opiate users = 15%, Cocaine users = 22% Odds of albuminuria: Opiates: OR 1.20, 95% CI 0.83–1.73 Cocaine: OR 1.80, 95% CI 1.29–2.51 | Odds of reduced eGFR: Opiates: OR 2.71, 95% CI 1.50–4.89 Cocaine: 1.40, 95% CI 0.87–2.24 |
CPD Opioids | |||
Briggs, 2013 [49] n = 33 | Case Control Case-15 Control-18 | 4/8 TTP without infection patients in the case group had renal failure and 7/7 TTP infection patients in the case group had renal failure. | (Odds ratio = 35.0; 95% confidence interval = 3.9–312.1) between TTP-like illness and injection of reformulated Opana ER |
Aghabiklooei et al., 2014 [140] n = 322 | Cross Sectional | Acute methadone toxicity – Total n = 322, Survivors n-294, Non survivors n- 28 Acute Renal failure: total 16 (4.9%), Survivors 3 (1%), Non Survivors 13 (46.4%) p < 0.001 | Rhabdomyolysis: Total 15 (4.6%), Survivors 7 (2.4%), Non-Survivors 8 (28.6%) |
Glanzmann et al., 2015 [47] n = 200 | Case Control Case = 100 Control =100 | AKI with morphine – OR- 2.4 (1.02, 6.03) p = 0.042 AKI with opioids drug group- OR 3.2 (1.35, 7.75) p = 0.008 | Age and sex was matched in cases and controls |
Cocaine | |||
Buettner et al. 2014 [55] | Case Series (autopsy) | 75/129 cocaine positive subjects Signs of glomerular ischemia with cocaine = OR 3.08 (1.35–7.01) p = 0.007 *; OR = 3.34 (1.37–8.14) p = 0.01**. Arteriosclerosis with cocaine = OR 2.35 (1.08–5.11) p = 0.02*; OR 3.88 (1.49–9.92) p = 0.005** | HTN-Ischemic Nephropathy with cocaine = OR 5.42 (1.17–25.20) p = 0.02*, OR = 6.0 (1.27–28.44) p = 0.02** |
Cocaine and Levamisole | |||
McGrath et al. 2012 [141] | Cross sectional | 30/327 New ANCA patients 100% had antimyeloperoxidase antibodies and 50% antiproteinase 3 antibodies, 2 cases had acute renal failure. | N/A |
Amphetamines | |||
Liechti et al., 2005 [142] n = 52 | Case Series | 90.4% used drugs in combination with Ecstasy 3 patients had rhabdomyolysis and 1 patient had acute renal failure | N/A |
CDC 2010 [83] | Case Series | One patient had renal failure, rhabdomyolysis and seizures who was admitted to the ICU and required hemodialysis. | N/A |
Jones et al., 2015 [143] | Cross Sectional | Methamphetamine User: N = 47, Malignant Hypertension present in 89.45 (n = 42), CKD was present in 95.7% (N = 45) (55.3% had stage 5 CKD, 8.4% had stage 4 CKD, 10.6% had stage 2 CKD and 12.8% had stage 1 CKD) | Biopsy Findings- Biopsy was performed on 24 patients, Hypertensive changes were present in 50% (N = 12) (with N = 6 had malignant changes), 25% (N = 6) had ESRD, MPGN Type 1 with IgM-C3 deposits was found in 58.3% (N = 14), 37.5% (N = 9) had IgG deposits and 29% (N = 7) had IgA deposits. |
Nicol et al. 2015 [87] | Case Series | All subjects’ death. 17/27 died after arrival to hospital. 85% AKI 54% Rhabdomyolysis | Median Peak Cr was 2.4 (1.7–12.8) mg/dl; Median Peak CK was 8200 (1952–237,960) U/L |
Author, Year | Age/Sex | Drug | Clinical Presentation | Findings | Findings |
---|---|---|---|---|---|
Price et al., 2010, [144] n = 1 | 30/M | Marijuana | Abdominal Pain, Nausea, Vomiting | Cr-3.2 mg/dL Urinalysis-Trace ketones | Acute Kidney Injury |
Baron et al., 2011 [145] n = 1 | 28/M | Marijuana | Vomiting | Cr-5.9 mg/dL | Acute Kidney Injury |
Abodunde et al., 2013, [146] n = 1 | 36/M | Marijuana | Nausea, Vomiting, lethargy | Cr-9.06 mg/dL | Acute Kidney Injury |
Chang et al., 2013 [147] n = 1 | 50/M | Marijuana | Vomiting, epigastralgia, Altered consciousness | Cr-10.1 mg/dL Urinalysis-PH 5.5 with bland sediment | Acute Kidney Injury |
Ukaigwe et al., 2014 [148], n = 1 | 38/M | K-2 | Abdominal Pain, Nausea, Vomiting | Cr-4.78 mg/dL, | Pre renal acute kidney Injury |
Habboushe et al., 2014 [24] n = 1 | 25/M | Marijuana | Nausea, Vomiting | Cr-3.21 mg/dL | Acute Kidney Injury |
Srihari et al., 2016 [149] n = 1 | 43/M | Cannabis | Epigastric pain, Nausea, Vomiting | Cr-2.54 mg/dL | Acute Kidney Injury |
Author, year | N, Age/Sex | Drug | Clinical Presentation | Findings | Diagnosis |
---|---|---|---|---|---|
Wiergowski et al., 2014 [150] | 31/M | Methoxetamine, Amphetamines | “lack of Information” | Peak Cr- 3.56 mg/dL Peak CK- 129,800 U/L Anuria +ve | Acute renal failure secondary to rhabdomyolysis |
Chenoweth et al., 2015 [96] | 27/M | Gacyclidine | Confused, combative | Peak Cr- 1.84 mg/dL Peak CK- 2413 U/L | Acute kidney injury and rhabdomyolysis |
49/M | Gacyclidine | Agitated | Peak Cr- 2.07 mg/dL Peak CK- 28,305 U/L | Acute kidney injury and rhabdomyolysis | |
47/M | Gacyclidine | Difficulty in ambulating | Peak Cr- 3.84 mg/dL Peak CK- 13,923 U/L | Acute kidney injury and rhabdomyolysis | |
47/M | Gacyclidine | Agitated and confused | Peak Cr- 1.47 mg/dL Peak CK- 1780 U/L | Acute kidney injury and rhabdomyolysis | |
47/M | Gacyclidine | Found unconscious next to a gas station | Peak Cr- 5.9 mg/dL Peak CK- 62,694 U/L; Dialysis +ve | Acute kidney injury and rhabdomyolysis |