Crack use kidney failure

But you'll get the drift - crack cocaine is hard on your kidneys. The patients had smoked cocaine for several years, often continuously, and presented with severe hypertension and renal insufficiency. Blood pressure was extremely elevated, often quite out of proportion to the degree of end organ damage and frequently quite refractory to treatment.

It has also been described that scleroderma renal crisis, characterized by accelerated hypertension, rapidly progressive renal failure and hyperreninaemia can be precipitated by heavy cocaine abuse [10]. Surprisingly, hypertension may be absent on presentation and severe renal arterio-arteriolosclerosis without hypertension has been reported after cocaine use [11,12]. Apart from rare cases with renal infarction [13], antiglomerular basement membrane antibody-mediated glomerulonephritis [14] or acute interstitial nephritis [15], the mechanisms leading to renal insufficiency after cocaine abuse are at present not clear.

Contact a licenced counselor if you're in crisis. Labels: kidney failure , renal failure. No comments:. Newer Post Older Post Home. Subscribe to: Post Comments Atom. FeedBurner FeedCount. Hypertension was thought to be a major factor [ 8 ], especially in black patients. It was speculated that the habitual use of cocaine might worsen hypertension, make it more difficult to control, thus precipitating hypertensive crises culminating in uraemia [ 8 ].

The association of acute hypertension with cocaine use has been well documented [ 8 , 16 ]. The acute effects are thought to be at least partially caused by vasoconstriction, such as has been described with ergotamine, epinephrine, and amphetamine derivatives [ 17 ]. Recently it was shown, however, that there are no differences of blood pressure in black cocaine users as compared to an appropriate age matched control group NHANES III study [ 17 ].

It was concluded that chronic cocaine use is associated with acute but not chronic hypertension in middle-aged black males. Cocaine did not cause microalbuminuria. Thus, the discussion about the relationship between cocaine abuse and chronic hypertension is not easy.

In an autopsy study of cocaine-induced cerebral haemorrhage, Cardiac hypertrophy can be associated with cocaine in the absence of hypertension, however [ 19 ].

Since it is known that cocaine may accelerate atherosclerosis in the aorta and coronary arteries, it has been speculated that a similar phenomenon may occur in the renal vasculature [ 11 ]. Few papers have systemically addressed the question whether chronic cocaine use directly leads to nephropathy. Barroso-Moguel et al. Renal histology showed early changes on day 15, with damage to glomerular capillary walls and swelling of tubular epithelium.

After 90 days lesions had progressed to glomerular atrophy and sclerosis. The tubular epithelial cells were necrotic and sloughed, and the lumen of papillary ducts contained destroyed red blood cell casts. The interstitium had numerous foci of necrosis and haemorrhage. Most unfortunately, data on the acute and chronic effects of cocaine on blood pressure, renal function or proteinuria were not given in the paper. DiPaolo et al.

Semi-quantitative analysis showed that the ratio of hyaline glomeruli to normal glomeruli was increased in the users as compared to the non-users 0. The increases in the dimensions of the arterial vessels such as lumen perimeter, intima perimeter, media perimeter, media and intima area as well as media thickness were also highly significant. A comparison of the histology from human autopsy material to the histology of the animal model shows little similarity.

The acute effects of maternal cocaine abuse on blood flow of the fetal kidney and the fetal hourly urine output were studied by Mitra et al. A retrospective study has suggested that cocaine exposure in utero leads to an increased incidence of hypospadia and an increased incidence of renal tract abnormalities [ 23 ]. Abnormalities included horseshoe kidney, unilateral abnormal small kidney, duplex kidney and renal tract dilatation. Prospective studies confirming these findings are lacking, but earlier studies in mice [ 24 ] have shown that intraperitoneal injection of cocaine may result in dilated or cystic ureters, hydronephrosis, grossly distended bladders, cryptochidism and renal artery ablation in addition to limb reduction abnormalities, gastrointestinal atresia and cardiac abnormalities.

Renal abnormalities are part of the spectrum of acute and chronic cocaine toxicity. Chronic cocaine abuse may damage the kidney not only in utero , but also later in life. Rhabdomyolysis and hypertension are important pathogenetic factors, but may not be the only mediators of renal disease; accelerated renal arteriosclerosis in cocaine users may occur in the absence of hypertension.

Studies in experimental animals or prospective studies in patients are surprisingly rare, so that knowledge of the relevant mechanisms and the extent of the problem is limited. Cocaine detection in a university population by hair analysis and skin swab testing. Forensic Sci Int ; 84 : 75 — Identifying adolescent drug users: results of a national survey on adolescent health in Switzerland. J Adolesc Health ; 16 : — Cregler LL, Mark H. Medical complications of cocaine abuse.

N Engl J Med ; 88 : — Acute rhabdomyolysis associated with cocaine intoxication. N Engl J Med ; : — Acute renal failure following cocaine abuse. Nephron ; 52 : 76 — Cocaine-associated rhabdomyolysis and excited delirium: different stages of the same syndrome.

Am J Forensic Med Pathol ; 20 : — Nolte KB. Rhabdomyolysis associated with cocaine abuse. Hum Pathol ; 22 : — Role of cocaine in end-stage renal disease in some hypertensive african americans. Am J Nephrol ; 15 : 5 —9. Case reports: cocaine-associated accelerated hypertension and renal failure. Am J Med Sci ; : — Cocaine-induced scleroderma and scleroderma renal crisis. South Med J ; 98 : — Severe arteriosclerosis in the kidney of a cocaine addict.

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