SHM Converge Scientific Abstract ePoster Gallery-Don't Temp Fate: "Meth" Abuse Accelerating Chronic Kidney Disease Progression.

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This case report highlights methamphetamine-associated kidney injury and the long-term risk of chronic kidney disease progression with continued use.<br /><br />A 56-year-old man with pre-existing CKD stage II and methamphetamine abuse presented with decreased urine output, dark “coffee-colored” urine, severe myalgias, back pain, and fatigue. Laboratory studies showed extreme rhabdomyolysis with CPK 218,000 U/L, marked transaminitis, metabolic acidosis, leukocytosis, and acute kidney injury (creatinine 3.68 mg/dL, rising later to 18.89 mg/dL). Urinalysis and renal ultrasound supported significant renal injury. He was treated with IV fluids, but by hospital day 10 he became anuric and required three hemodialysis sessions.<br /><br />After dialysis, urine output improved and creatinine stabilized, eventually returning to baseline two months after discharge. However, because he continued methamphetamine use, his kidney function deteriorated over the next two years and progressed to CKD stage III.<br /><br />The discussion emphasizes that methamphetamine can damage the kidneys through several mechanisms: vasoconstriction, direct nephrotoxicity, and non-traumatic rhabdomyolysis causing myoglobin-induced tubular injury. Although meth-associated AKI is often thought to be mild and reversible, repeated episodes can lead to recurrent AKI, irreversible renal damage, and progression to CKD or even ESRD.<br /><br />The authors conclude that clinicians should maintain a high index of suspicion for AKI in patients using methamphetamine, promptly treat rhabdomyolysis and kidney injury, address substance use disorder, and counsel patients that continued use may accelerate irreversible CKD progression.

Asset Subtitle

Katsiaryna Murashka

Meta Tag

Author List Julia Torrellas, Katsiaryna Murashka, Violetta Laskova

Category Clinical Vignettes

Concept Methamphetamine Use

Concept Acute Kidney Injury

Concept Kidney Injury

Concept Rhabdomyolysis

Concept Chronic Kidney Disease

Distinguished Non-Finalist

Presenter Organization Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, NY, New York

Presenting Author Katsiaryna Murashka

Track Adult

Keywords

methamphetamine

kidney injury

chronic kidney disease

rhabdomyolysis

acute kidney injury

hemodialysis

myoglobinuria

renal failure

substance use disorder

CKD progression

Methamphetamine Use

Acute Kidney Injury

Kidney Injury

Rhabdomyolysis

Chronic Kidney Disease