Recurrent acute kidney injury following bath salts intoxication

"Bath salts" are becoming recognized as a frequently abused and highly addictive substance that can be obtained legally in some areas. These agents contain stimulant compounds, such as methylenedioxopyrrovalerone and mephedrone, that have been associated with sympathomimetic effects and psychotic features, such as paranoia, delusions, agitation, and confusion. They may have a benign course; however, intoxication with these agents may lead to severe cardiovascular and neurologic complications and death. We report a case of recurrent acute kidney injury associated with repeated bath salts intoxication. The patient, who presented with neurologic and cardiovascular symptoms and signs, also developed rhabdomyolysis, hyperuricemia, and metabolic acidosis as part of the clinical presentation. Bath salts intoxication should be included on the list of substances that can cause acute kidney injury and other metabolic abnormalities.