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What Do We Know about Opioids and the Kidney?

Mary Mallappallil1, Jacob Sabu2, Eli A Friedman3

  • 1Department of Internal Medicine, State University of New York at Downstate, Brooklyn, New York, NY 11203, USA. marynephrology@yahoo.com.

International Journal of Molecular Sciences
|January 25, 2017
PubMed

Insights

Opioid use is linked to kidney disease, causing acute and chronic kidney injury. This review examines opioid effects on renal function, considering safe use and toxicity risks amid rising global consumption.

Area of Science:

  • Nephrology
  • Pharmacology
  • Toxicology

Background:

  • Growing global use of opioids for medical and recreational purposes necessitates understanding their impact on kidney health.
  • Opioid use is increasingly associated with adverse renal outcomes.
  • Existing literature on opioid-induced nephrotoxicity requires comprehensive synthesis.

Purpose of the Study:

  • To review the renal manifestations associated with opioid use.
  • To explore the direct and indirect effects of opioids on kidney injury.
  • To discuss the safe use of opioids in patients with pre-existing kidney disease and address toxicity concerns.

Main Methods:

  • Systematic literature review of studies investigating opioid use and kidney disease.
  • Analysis of evidence on acute kidney injury (AKI) and chronic kidney disease (CKD) related to opioids.
  • Examination of pharmacological and contextual factors contributing to renal failure.

Main Results:

  • Opioid use is associated with various renal manifestations, including acute and chronic kidney injury.
  • Both direct drug toxicity and indirect effects (e.g., rhabdomyolysis, infections) contribute to kidney damage.
  • Opioids can be used safely for pain management in patients with kidney disease, but careful monitoring for side effects is crucial.

Conclusions:

  • Opioid-induced nephrotoxicity is a significant concern, particularly with increased global usage.
  • Understanding the mechanisms of renal injury is vital for mitigating risks.
  • Balancing the benefits of opioid analgesia with potential renal toxicity is essential for patient care.
Keywords:
opioidspharmacokineticsrenal failure

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