title: AKI associated with synthetic cannabinoids: a case series.
abstract: SPICE, or K2, encompasses preparations of synthetic cannabinoids marketed as incense products, bath additives, and air fresheners and used for recreational purposes. These preparations are usually smoked for their cannabis-like effects and do not appear on routine urine toxicology screens. We report four cases of oliguric AKI associated with SPICE use in previously healthy men. All showed improvement in renal function without need for renal replacement therapy. Renal biopsy, performed in three of the patients, revealed acute tubular necrosis. The close temporal and geographic associations between the clinical presentation and the development of AKI strongly suggest an association between these SPICE preparations and AKI. Further investigations are required to identify the potential nephrotoxic agent(s). Nephrotoxicity from designer drugs should be included in the differential diagnosis of AKI, especially in young adults with negative urine drug screens.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, University of Alabama, Birmingham, AL, USA.
authors.forename: Gautam Kantilal
authors.initials: GK
authors.lastname: Bhanushali
authors.forename: Gaurav
authors.initials: G
authors.lastname: Jain
authors.forename: Huma
authors.initials: H
authors.lastname: Fatima
authors.forename: Leah J
authors.initials: LJ
authors.lastname: Leisch
authors.forename: Denyse
authors.initials: D
authors.lastname: Thornley-Brown
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000175:diagnosis; D000328:Adult; D002186:Cannabinoids / Q000009:adverse effects*; D015198:Designer Drugs / Q000009:adverse effects*; D003937:Diagnosis, Differential; D006801:Humans; D007683:Kidney Tubular Necrosis, Acute / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D009846:Oliguria / Q000139:chemically induced / Q000175:diagnosis; D055815:Young Adult
chemical_list: D002186:Cannabinoids; D015198:Designer Drugs