title: Bath salt intoxication causing acute kidney injury requiring hemodialysis.
abstract: Traditional bath salts contain a combination of inorganic salts like Epsom salts, table salt, baking soda, sodium metaphosphate, and borax that have cleansing properties. Since 2010, there have been rising concerns about a new type of substance abuse in the name of "bath salts." They are beta-ketone amphetamine analogs and are derivates of cathinone, a naturally occurring amphetamine analog found in the "khat" plant (Catha edulis). Effects reported with intake included increased energy, empathy, openness, and increased libido. Serious adverse effects reported with intoxication included cardiac, psychiatric, and neurological signs and symptoms. Not much is known about the toxicology and metabolism of these compounds. They inhibit monoamine reuptake (dopamine, nor epinephrine, etc.) and act as central nervous system stimulants with high additive and abuse potential because of their clinical and biochemical similarities to effects from use of cocaine, amphetamine, and 3,4-methylenedioxy-N-methylamphetamine. Deaths associated with use of these compounds have also been reported. We report a case of acute kidney injury associated with the use of "bath salt" pills that improved with hemodialysis.
authors.affiliation: Department of Internal Medicine, University of Missouri, Columbia, Missouri 65212, USA. regunathh@health.missouri.edu
authors.forename: Hariharan
authors.initials: H
authors.lastname: Regunath
authors.forename: Venkatesh Kumar
authors.initials: VK
authors.lastname: Ariyamuthu
authors.forename: Pranavkumar
authors.initials: P
authors.lastname: Dalal
authors.forename: Madhukar
authors.initials: M
authors.lastname: Misra
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000134:cerebrospinal fluid / Q000139:chemically induced* / Q000628:therapy* / Q000652:urine; D000328:Adult; D000470:Alkaloids / Q000008:administration & dosage / Q000009:adverse effects* / Q000737:chemistry; D001494:Baths; D029754:Catha / Q000009:adverse effects* / Q000737:chemistry; D006801:Humans; D008297:Male; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000009:adverse effects* / Q000737:chemistry; D006435:Renal Dialysis; D012492:Salts
chemical_list: D000470:Alkaloids; D011619:Psychotropic Drugs; D012492:Salts; C023665:cathinone