Table 1 Summary of Case reports and Case series of Synthetic Cannabinoids, Bath Salts, Heroin, Amphetamines, Cocaine, Cocaine and Levamisole and CPD – Opioids
From: Systematic review of nephrotoxicity of drugs of abuse, 2005–2016
Cocaine [11, 57,58,59,60,61,62,63, 66, 71, 118,119,120,121,122,123,124,125,126,127,128] | Cocaine & Levamisole [17, 70, 72,73,74,75,76, 129,130,131,132,133] | ||||||
|---|---|---|---|---|---|---|---|
# 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) |