Spectrum of Kidney Biopsy Findings Associated With Methamphetamine Use

Area of Science:

• Nephrology
• Toxicology
• Drug Abuse Research

Background:

• Methamphetamine (METH) is a widely abused illicit drug with underreported nephrotoxic effects.
• Limited data exists on the spectrum of kidney damage and histopathological changes associated with METH use.

Purpose of the Study:

• To investigate the renal toxic effects and histopathological findings in patients with a history of METH abuse.
• To characterize the kidney biopsy findings in METH users, differentiating between METH-only and poly-substance users.

Main Methods:

• Retrospective analysis of 112 patients with METH abuse history.
• Categorization into METH-only (62 patients) and METH plus other drugs (60 patients) cohorts.
• Review of kidney biopsy results and clinical data.

Main Results:

• 97% of METH users showed kidney dysfunction; 65% had proteinuria. Common diagnoses included acute tubular necrosis (ATN, 66%) and focal segmental glomerulosclerosis (FSGS, 53%).
• Tubulointerstitial nephritis (TIN), thrombotic microangiopathy (TMA), and diabetic glomerulosclerosis (DG) were also prevalent.
• Myoglobinuric ATN was associated with concurrent ethanol abuse (P=0.002), and METH-only users showed higher rates of DG (P=0.01).

Conclusions:

• METH use is associated with a broad range of kidney pathologies, frequently presenting as acute kidney injury (AKI) and proteinuria.
• Histopathological findings underscore the significant nephrotoxic potential of METH, necessitating clinical awareness and further research.