title: Heroin crystal nephropathy.
abstract: In this paper we present an interesting case of acute kidney injury and severe metabolic alkalosis in a patient with a history of heavy heroin abuse. Urine microscopy showed numerous broomstick-like crystals. These crystals are also identified in light and electron microscopy. We hypothesize that heroin crystalizes in an alkaline pH, resulting in tubular obstruction and acute kidney injury. Management is mainly supportive as there is no known specific therapy for this condition. This paper highlights the utility of urine microscopy in diagnosing the etiology of acute kidney injury and proposes a novel disease called heroin crystal nephropathy.
authors.affiliation: Division of Kidney Disease and Hypertension, Department of Medicine , Rhode Island Hospital, Brown University School of Medicine , Providence, RI , USA.
authors.forename: Josef Edrik Keith
authors.initials: JE
authors.lastname: Bautista
authors.affiliation: Division of Kidney Disease and Hypertension, Department of Medicine , Rhode Island Hospital, Brown University School of Medicine , Providence, RI , USA.
authors.forename: Basma
authors.initials: B
authors.lastname: Merhi
authors.affiliation: Department of Medicine , Rhode Island Hospital, Brown University School of Medicine , Providence, RI , USA.
authors.forename: Oliver
authors.initials: O
authors.lastname: Gregory
authors.affiliation: Division of Kidney Disease and Hypertension, Department of Medicine , Rhode Island Hospital, Brown University School of Medicine , Providence, RI , USA.
authors.forename: Susie
authors.initials: S
authors.lastname: Hu
authors.affiliation: Department of Pathology , University of Chicago Medical Center , Chicago, IL , USA.
authors.forename: Kammi
authors.initials: K
authors.lastname: Henriksen
authors.affiliation: Division of Kidney Disease and Hypertension, Department of Medicine , Rhode Island Hospital, Brown University School of Medicine , Providence, RI , USA.
authors.forename: Reginald
authors.initials: R
authors.lastname: Gohh
keywords: acute kidney injury; crystal nephropathy; heroin nephropathy; urinalysis; urine microscopy