title: Acute kidney injury due to rhabdomyolysis in narcotic drug users.
abstract: BACKGROUND
  Regular or illegal drugs and toxins are the most frequent non-physical causes of rhabdomyolysis (RM) in peacetime. Acute kidney injury (AKI) is a serious and, sometimes, fatal complication of RM. It occurs in 8-20% of RM incidents.
  
  
  METHODS
  In this prospective study we evaluated the severity of RM and AKI in narcotic drug users. From January 2001 to December 2007, 21 patients (17 males, mean age 27.8±4.8 years) with RM associated with AKI were classified into two groups: 11 heroin users (HU) and 10 non-heroin users (NHU). The severity of RM was evaluated by estimation, on admission, of serum creatine phosphokinase (CPK), serum glutamic oxaloacetic transaminase (SGOT), lactate dehydrogenase (LDH), phosphate (PO4 ) and calcium (Ca) and by the presence of paraplegia (PPL). The severity of AKI during hospitalization was evaluated by estimation of serum creatinine (CR), the presence of oligoanuria (OA), the days of hospitalization (DH), the total of hemodialysis treatments (THD) and the number of patients who received blood transfusions (BT).
  
  
  RESULTS
  RM was much more severe in HU than in NHU. Mean SGOT, CPK, LDH, and P values on admission were higher in HU. Hypocalcemia was statistically more severe in HU. Nine HU were admitted with PPL vs. 1 NHU. Serum CR levels were higher and oligoanuria was much more common in HU. HU had a longer hospitalization period and underwent a bigger number of HT. More HU took BT.
  
  
  CONCLUSIONS
  The results of this study suggest that both RM and ARF are more severe in HU than in NHU possibly due to an additional myotoxic effect of heroin.
authors.affiliation: Gregorios Vosnides Department of Nephrology, Laiko General Hospital, Athens, Greece. George.Kosmadakis@googlemail.com
authors.forename: George
authors.initials: G
authors.lastname: Kosmadakis
authors.forename: Otho
authors.initials: O
authors.lastname: Michail
authors.forename: Vasileios
authors.initials: V
authors.lastname: Filiopoulos
authors.forename: Panoraia
authors.initials: P
authors.lastname: Papadopoulou
authors.forename: Spiridon
authors.initials: S
authors.lastname: Michail
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000328:Adult; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001803:Blood Transfusion; D016009:Chi-Square Distribution; D055030:Drug Users; D005260:Female; D006115:Greece; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D007902:Length of Stay; D008297:Male; D009293:Opioid-Related Disorders / Q000150:complications*; D010343:Patient Admission; D011446:Prospective Studies; D012206:Rhabdomyolysis / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers