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Published on: July 3, 2013
The effect of chronic renal failure on the benzoylecgonine blood level: a case report
Daniel A Guillaud1, Prentiss Jones, Joseph A Prahlow
1From the *Indiana University School of Medicine, Indianapolis; and †The Medical Foundation; and Indiana ‡University School of Medicine-South Bend, South Bend, IN.
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.
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