Renal lipidosis in patients enrolled in a methadone substitution program.
Kidney biopsies often show accumulation of lipids or lipidlike material. Evidence has been provided that lipids can directly initiate and contribute to the progression of glomerular and tubulointerstitial lesions. In this study we describe a renal lipidosis occurring in patients with a positive history of narcotic abuse who were enrolled in a methadone substitution program. All 3 patients presented with proteinuria (2.5-20 g/d) and impaired renal function. Renal biopsy revealed a pronounced extracellular and intracellular deposition of lipidlike material in the glomerular, interstitial, and tubular compartments. Known causes of lipid storage could be excluded clinically and morphologically. We consider this to be a distinct renal lipidosis associated with narcotic abuse, methadone intake, or intravenous abuse thereof.
From the Department of Cellular and Molecular Pathology, German Cancer Research Center, Heidelberg, Germany (Drs Porubsky and Gröne); the Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany (Dr Porubsky); the Department of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany (Drs Kuppe, Moeller, and Floege); the Department of Internal Medicine, University Hospital Giessen and Marburg, Marburg, Germany (Dr Maier); the Department of Internal Medicine, University Hospital Giessen and Marburg, Giessen, Germany (Dr Birk); and the Medical Clinic and Policlinic, University Hospitals LMU, Munich, Germany (Dr Wörnle). Drs Porubsky and Kuppe contributed equally to the manuscript.
Stefan
S
Porubsky
Christoph
C
Kuppe
Tanja
T
Maier
Horst-Walter
HW
Birk
Markus
M
Wörnle
Marcus J
MJ
Moeller
Jürgen
J
Floege
Hermann-Josef
HJ
Gröne
D000328:Adult; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000473:pathology; D007674:Kidney Diseases / Q000175:diagnosis* / Q000378:metabolism; D050356:Lipid Metabolism; D008064:Lipidoses / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D008691:Methadone / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000009:adverse effects*; D009293:Opioid-Related Disorders / Q000188:drug therapy
D008691:Methadone