What Can Happen to the Renal System as a Result of Excessive Drug Use?

Tobacco Products

Nicotine contained in tobacco products is a toxic substance, and it can be toxic to the kidneys. Use of nicotine increases blood pressure, and this increase can accelerate damage to the kidneys. Nicotine also exacerbates kidney disease and increases the risk of kidney failure in individuals who have certain medical conditions such as type I diabetes.

Smoking is associated with many complications that can affect kidney functioning, including:

• Increased rate of kidney disease in people with medical conditions like hypertension or diabetes
• Increase in levels of albumin (a type of protein) in urine that can be associated with cardiovascular disease
• Narrowing of the renal arteries (renal artery stenosis)
• Disruption of the balance of fluid and electrolytes in the system
• Inflammation of the kidneys

Alcohol Chronic heavy use of alcohol can lead to direct damage to the renal system, as the chronic use of alcohol can directly damage nearly every organ in the body. Such use can significantly alter the structure and function of the kidneys.

Alcohol use also affects the liver and how the liver and kidneys work together. Damage to the liver can affect kidney functioning. Even moderate to mild alcohol consumption will affect any existing condition of the liver, which will indirectly result in kidney damage.

Chronic heavy alcohol consumption can also:

• Lead to kidney swelling, which can impair renal functioning
• Alter the cells in the kidneys, leading to impaired functioning
• Produce electrolyte disturbances, which can disrupt the function of the kidneys
• Produce depletion of minerals that can lead to kidney dysfunction (e.g. calcium, magnesium, and/or potassium)
• Alter the acidity levels of the fluids in the system, which can result in alcoholic ketoacidosis, a condition that is characterized by a significantly dangerous high blood acidity level, and produce alkalosis or low acidity in the fluids
• Result in fluid accumulation in the system, which can disrupt the functioning of the kidneys

It is well documented that chronic heavy consumption of alcohol can result in liver disease. Because the liver and kidneys work together, the effects of liver disease can extend to the renal system. For instance, it is not uncommon for individuals who have cirrhosis of the liver to also have enlarged kidneys. Individuals with liver damage as a result of cirrhosis of the liver are also at a higher risk for acute kidney failure and issues with electrolyte and sodium imbalances that can also lead to kidney damage.

Cocaine

Cocaine is a central nervous system stimulant that has been demonstrated to have significant detrimental effects on kidney functioning. Cocaine use, particularly heavy and chronic use, can lead to a condition known as rhabdomyolysis where muscle tissue breaks down and enters the bloodstream. This condition can lead to kidney failure.

Nearly one-third of individuals who are admitted to emergency rooms with cocaine-related issues will also develop acute kidney failure. Cocaine can also lead to renal infarctions (dead tissue on the kidneys), and chronic use is associated with cardiovascular issues, such as atherosclerosis in the walls of the renal arteries (the buildup of plaque). This can also lead to kidney damage, disruptions in kidney functioning, and issues with abdominal pain, nausea, and vomiting.

Ecstasy

Ecstasy (MDMA) is a synthetic drug that is classified as a dissociative hallucinogenic drug. It produces hallucinations and feelings of leaving one’s body or being out of touch with reality. The drug has numerous side effects that can lead to issues with renal functioning, including its ability to increase body temperature (produce hyperthermia), which can lead to dehydration. This can result in rhabdomyolysis and acute renal failure.

The drug can also exacerbate hypertension, and this can lead to acute renal failure or damage to the kidneys.

Inhalant Use

Household items, such as spray paint, cleaning fluids, and glues, are often used as inhalants by individuals attempting to achieve the psychoactive effects associated with these substances. A toxic chemical known as toluene, which is a component of many substances used as solvents or glues that are abused as inhalants, can lead to direct kidney damage when ingested. The damage will often occur as the result of lesions to the kidney. It may also produce a serious condition known as renal tubular acidosis in which acid builds up in the blood and can lead to chronic kidney failure.

Opiates

Opiate drugs consist of numerous pain-relieving (analgesic) prescription drugs and several drugs that are illicit, such as heroin. These are high-profile drugs of abuse in the United States, and their abuse is associated with numerous health issues.

The drugs can be taken orally, ground up and mixed with liquid and injected, and even snorted. There is a significant risk associated with injecting any type of drug when individuals share needles and may contact a blood-borne virus. Opiate abusers who inject drugs are at a high risk to share needles and may contract HIV-associated nephropathy, which is a kidney disease that often affects individuals who are intravenous drug users and have HIV. This condition may progress to end-stage kidney failure and death.

In addition to the risks associated with injecting drugs, the use of opiate drugs can result in kidney damage through numerous mechanisms.

• Intravenous drug users (e.g., heroin users) are more likely to contract fungal and bacterial infections, which can result in acute kidney inflammation.
• Intravenous drug users have an increased risk of buildup of protein in organs and tissues associated with chronic infections and inflammation (secondary amyloidosis). This can progress to kidney failure.
• Opiate overdose can lead to rhabdomyolysis, which can amplify the risks of kidney damage.
• Many opiate drugs also contain acetaminophen (e.g., Vicodin and Percocet). Taking large doses of acetaminophen or chronic use of acetaminophen can be associated with liver damage, which can affect kidney functioning.
• Long-term use of acetaminophen can also produce analgesic neuropathy, an irreversible condition that can progress to renal failure, or chronic kidney failure.