Cocaine-associated acute myoglobinuric renal failure.
OBJECTIVE
Abuse of cocaine is associated with serious medical complications involving the heart, central nervous system, and gastrointestinal tract. Renal complications appear to be uncommon. We describe herein four patients with rhabdomyolysis and acute myoglobinuric renal failure temporally related to cocaine use.


METHODS
Acute cocaine intoxication was the most common presentation and rhabdomyolysis was an unexpected finding. Renal failure progressed rapidly in all patients, necessitating dialysis in two. The prognosis was good, and all patients survived. The mechanism of cocaine injury is unclear; possibilities include increased muscle activity, muscle compression, hyperthermia, and vasospasm with muscle ischemia.


CONCLUSIONS
Rhabdomyolysis with acute renal failure should be recognized as a possible complication of cocaine abuse.
Pogue
V A
VA
Department of Medicine, Harlem Hospital Center, College of Physicians and Surgeons, New York, New York 10037.
Nurse
H M
HM
D058186:Acute Kidney Injury / Q000209:etiology*; D000328:Adult; D001774:Blood Chemical Analysis; D003042:Cocaine / Q000652:urine; D006801:Humans; D008297:Male; D009212:Myoglobinuria / Q000209:etiology*; D012206:Rhabdomyolysis / Q000209:etiology*; D019966:Substance-Related Disorders / Q000150:complications*
D003042:Cocaine