title: Lifetime Cocaine and Opiate Use and Chronic Kidney Disease.
abstract: More than 50% of American adolescents and adults report having used illicit drugs in their lifetime. We examined the association of lifetime opiate and cocaine use with reduced kidney function, albuminuria and rapid kidney function decline among urban-dwelling adults.
  
  
  
  Our prospective cohort included 2,286 Healthy Aging in Neighborhoods of Diversity across the Life Span study participants who were community-dwelling adults residing in Baltimore, MD. The predictive variables were lifetime opiate and cocaine use, defined as use of opiates or crack/cocaine ≥5 times. Outcomes included prevalent reduced estimated glomerular filtration rate (eGFR; <60 ml/min/1.73 m2 by Chronic Kidney Disease (CKD)-Epidemiology Collaboration), albuminuria (albumin-to-creatinine ratio >30 mg/g, n = 1,652) and rapid kidney function decline (>3 ml/min/1.73 m2 per year over a median of 4.7 years, n = 1,660).
  
  
  
  Participants' mean age was 48 years, 15% reported opiate use, and 22% reported cocaine use. A total of 115 (5.0%) participants had reduced eGFR, 190 (11.5%) had albuminuria and 230 (13.8%) experienced rapid decline in kidney function. In adjusted logistic regression analyses, both substances were associated with greater odds of reduced eGFR (OR 2.71, 95% CI 1.50-4.89 for opiates; OR 1.40, 95% CI 0.87-2.24 for cocaine). Both substances were associated with greater odds of albuminuria (OR 1.20, 95% CI 0.83-1.73 for opiates; OR 1.80, 95% CI 1.29-2.51 for cocaine). Neither substance was associated with the rapid decline of kidney function.
  
  
  
  Lifetime opiate and cocaine use was associated with prevalent reduced eGFR and albuminuria, yet not with rapid kidney function decline. The use of opiate and cocaine may be an important risk factor for CKD in urban populations.
authors: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md., USA.
authors: Tessa
authors: T
authors: Novick
authors: Yang
authors: Y
authors: Liu
authors: Anika
authors: A
authors: Alvanzo
authors: Alan B
authors: AB
authors: Zonderman
authors: Michele K
authors: MK
authors: Evans
authors: Deidra C
authors: DC
authors: Crews
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000139:chemically induced; D003042:Cocaine / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D007668:Kidney / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D053610:Opiate Alkaloids / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced*; D012307:Risk Factors
chemical_list: D013287:Illicit Drugs; D053610:Opiate Alkaloids; D003042:Cocaine