title: The effect of chronic renal failure on the benzoylecgonine blood level: a case report.
abstract: Chronic renal failure results in reduced elimination of a variety of substances within the blood, including numerous drugs and their metabolites. This report describes a case of a man who died in jail, after less than 48 hours of being incarcerated, wherein postmortem toxicology testing revealed a blood benzoylecgonine level of 0.25 mg/L with no cocaine detected, suggesting possible recent cocaine use in jail. Autopsy and investigation revealed severe underlying cardiovascular disease and dialysis-dependent CRF, thus accounting for the elevated benzoylecgonine levels and allaying concerns that the man obtained and used cocaine in jail.
authors.affiliation: From the *Indiana University School of Medicine, Indianapolis; and †The Medical Foundation; and Indiana ‡University School of Medicine-South Bend, South Bend, IN.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Guillaud
authors.forename: Prentiss
authors.initials: P
authors.lastname: Jones
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Prahlow
mesh_terms: D000328:Adult; D003042:Cocaine / Q000031:analogs & derivatives* / Q000097:blood / Q000493:pharmacokinetics; D019970:Cocaine-Related Disorders / Q000097:blood; D003324:Coronary Artery Disease / Q000473:pathology; D053593:Forensic Toxicology; D006801:Humans; D006973:Hypertension / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D009294:Narcotics / Q000097:blood* / Q000493:pharmacokinetics; D011329:Prisoners
chemical_list: D009294:Narcotics; C005618:benzoylecgonine; D003042:Cocaine