The effects of methamphetamine intoxication on acute kidney injury in Iraqi male addicts.

Abstract

Methamphetamine (METH), a synthetic derivative of amphetamine, is prescribed for disorders such as narcolepsy but is sometimes illicitly produced from over-the-counter drugs like pseudoephedrine to produce "crystal meth." Consumption of METH can have a severe impact on a number of organ systems, including renal failure, neurotoxicity, pulmonary toxicity, and cardiotoxicity. Increased doses of METH can elevate blood pressure and heart rate, hence enhancing the chance of serious repercussions. Acute renal failure associated with METH is linked to kidney issues such as renal tubular necrosis, caused by reduced blood flow, and acute interstitial nephritis, which damages kidney tubules and impairs waste filtration. Biomarkers such as elevated serum levels of urea, creatinine, cystatin C, and neutrophil gelatinase-associated lipocalin (NGAL) indicate acute kidney injury (AKI). METH-induced renal failure often correlates with hyperthermia, hemodynamic instability, rhabdomyolysis, and nephropathies like necrotizing angiitis, tubular necrosis, and interstitial nephritis. This study investigates the association between kidney toxicity and AKI in Iraqi males with METH addiction. The research, carried out at Ibn-Rushed Psychiatric Hospital in Baghdad between January and August 2023, involved 168 males aged 22-43 who had been addicted for over 60 months. Additionally, 154 healthy males with no history of drug use served as controls. Drug test screening cards were utilized to confirm the diagnosis. Kidney function tests (urea, creatinine), total protein, serum albumin, sodium ions, cystatin C, creatine kinase, and NGAL levels were assessed. Results revealed significant differences between addicts and controls, particularly elevated cystatin C, creatine kinase, and NGAL levels in addicts. A ROC curve analysis demonstrated heightened sensitivity of kidney function tests to METH-induced renal damage. Histopathological examination of a deceased male, aged 41-year-old, with a seven-year history of METH abuse revealed evidence of acute kidney injury, accompanied by significantly elevated levels of renal function biomarkers. The findings suggest that prolonged methamphetamine use may have contributed to severe renal impairment, manifesting in both structural damage to the kidneys and a marked disruption in renal function. This study highlights the severe impact of METH on kidney function and underscores the importance of preventive measures and effective treatment strategies for managing METH addiction and mitigating its harmful effects.