Which Drugs of Abuse Have Nephrotoxic Effects?

the MPR take:

While information on the nephrotoxic effects of prescription medications may be readily accessible, for healthcare professionals, the effects that illegal drugs of abuse have on the kidneys may not be as apparent. A study published in the Clinical Journal of the American Society of Nephrology reviews the nephrotoxic effects of common and emerging drugs of abuse including anabolic androgenic steroids, synthetic cannabinoids, 3,4-Methylenedioxymethamphetamine (ecstasy), and cocaine. Long-term abuse of anabolic steroids has been associated with severe forms of focal segmental glomerulosclerosis (FSGS) while synthetic cannabinoids, which have recently become popular recreational drugs, have been linked to an atypical form of acute kidney injury.  The toxic effects of ecstasy include rhabdomyolysis, cardiovascular collapse, hyperthermia, and hypotonic hyponatremia because of its arginine vasopressin secretagogue-like effects. Cocaine on its own can cause vasoconstriction and rhabdomyolosis, but recent reports of cocaine adulteration with levamisole, an antihelminthic, have led to reports of antineutrophil cytoplasmic antibody (ANCA)-associated systemic vasculitis. Clinicians should be aware of the nephrotoxicities of these illegal drugs given their widespread abuse.

The kidneys can be injured in diverse ways by many drugs, both legal and illegal. Novel associations and descriptions of nephrotoxic effects of common and emerging drugs of abuse have appeared over the past several years.

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