Acute renal failure cocaine abuse

Singhal P, Horowitz B, Quinones MC, Sommer M, Faulkner M, Grosser M. Acute renal failure following cocaine abuse. Nephron 1989 52(l) 76-8. 

Faulkner M, Singhal P, Peters A. Rhabdomyolysis and acute renal failure following cocaine abuse. Kidney Int 1989 35 225A. 

Singhal PC, Rubin RB, Peters A, Santiago A, Neugarten J. Rhabdomyolysis and acute renal failure associated with cocaine abuse. Clin Toxicology 1990 28 321 -330. 

Cocaine is a central nervous system stimulant that inhibits the peripheral re-uptake of catecholamines, leading to increased sympathomimetic activity [115]. Its abuse is associated with a variety of medical problems. These include acute myocardial infarction, cardiac arrhythmias, cerebrovascular accidents, hyperpyrexia and stimulated sympathetic activity, seizures and coma, obstetrical complications, intestinal ischemia, and a variety of psychiatric complications [114-117]. The most prominent renal complication of cocaine abuse is acute renal failure associated with rhabdomy-olysis. 

Amphetamines have also been associated with a syndrome of acute kidney injury and rhabdomyolysis. Several series have described patients following intravenous injection of methamphetamine or phenmetrazine who presented with hyperactivity, fever, chills, sweats, abdominal cramps, diarrhea, and hypotension [177,178]. The patients have developed acute kidney injury which is usually oliguric and associated with classic rhabdomyolysis, similar to cases of cocaine-induced rhabdomyolysis. Several patients have had disseminated intravascular coagulation and liver function abnormalities as well. Methamphetamine abuse has also been associated with accelerated hypertension, unexplained chronic renal failure, acute lead poisoning (a common reagent used in its production utilizes lead acetate) and at least one case of biopsy proven interstitial nephritis the latter patient responded to intravenous corticosteroids but whether the nephritis was truly due to amphetamines remains unproven [179]. 

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