Drugs of abuse and kidney toxicity

The increasing consumption of drugs of abuse represents a global public health concern. Kidneys are especially vulnerable to the toxic effects of these substances, as these organs are involved in their filtration, concentration and metabolism to potentially toxic metabolites. Distinct clinical manifestations known to precede acute and chronic kidney injury (e.g., rhabdomyolysis, vasoconstriction, decreased estimated glomerular filtration rate) have been reported for different drugs of abuse (e.g., cannabinoids, cocaine, opioids, substituted phenethylamines). However, the underlying mechanisms remain poorly understood. As such, we herein review the most recent updates on the nephrotoxicity associated with drugs of abuse, as understanding their nephrotoxic profile assumes major relevance to improve risk assessment and therapeutic responses to drug-related complications.