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Heroin nephropathy. A clinicopathologic and epidemiologic study

E E Cunningham, J R Brentjens, M A Zielezny

    The American Journal of Medicine
    |January 1, 1980
    PubMed
    Summary

    Intravenous heroin use is linked to a specific kidney disease called sclerosing glomerulonephritis and end-stage renal disease (ESRD) in black men. This study confirms heroin as a significant risk factor for ESRD in the Buffalo area.

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    Area of Science:

    • Nephrology
    • Epidemiology
    • Toxicology

    Background:

    • The association between intravenous narcotic use and kidney disease, specifically nephropathy, has been debated.
    • Previous studies have not definitively established a link between heroin use and renal pathology.

    Purpose of the Study:

    • To investigate the potential association between heroin use and renal disease.
    • To determine if heroin abuse is a risk factor for sclerosing glomerulonephritis and end-stage renal disease (ESRD).

    Main Methods:

    • A 10-year clinicopathologic study of 23 intravenous drug users with nephrotic syndrome or renal insufficiency in the Buffalo SMSA.
    • Epidemiologic evaluation over 4.5 years to assess the correlation between heroin use and renal disease incidence.
    • Kidney biopsies were performed on 21 patients, uniformly showing sclerosing glomerulonephritis.

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    Main Results:

    • All 23 patients were black men aged 18-45.
    • Kidney biopsies revealed sclerosing glomerulonephritis in all cases.
    • Fifteen patients developed end-stage renal disease (ESRD).
    • Heroin use showed a strong correlation with sclerosing glomerulonephritis and ESRD (p < 0.000001).
    • 26% of new sclerosing glomerulonephritis cases and 13% of new ESRD cases in the study group had a history of intravenous heroin use.

    Conclusions:

    • This study confirms the existence of heroin-associated sclerosing glomerulonephritis in black men.
    • Intravenous heroin use is identified as a major risk factor for developing ESRD in the Buffalo SMSA.