Uro and nephrotoxic effects of drugs of abuse: Literature review and pharmaco-epidemiological survey in France and in the Marseille area

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Marion Gully, Elisabeth Frauger, Michel Spadari, Liselotte Pochard, Vanessa Pauly, Fanny Romain, Bertrand Gondouin, Marion
Sallee, Julie Moussi-Frances, Stephane Burtey, Bertrand Dussol, Laurent Daniel, Joelle Micallef and Noemie Jourde-Chiche

Centre de Nephrologie et Transplantation Renale, France
Aix-Marseille University, France

: J Nephrol Ren Dis

Abstract

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A great diversification of drugs of abuse has been observed in recent years, both in the population using them and in the types of drugs. Although dependency and psychiatric disorders associated are well known, uro-nephrotoxicity are less recognized. We propose here an overview of the products used by drugs abusers in France, through the analysis of the national pharmaco-epidemiological study “Observation des Produits Psychotropes Illicites ou Détournés de leur Utilisation Médicamenteuse” (OPPIDUM). Among the 5003 patients who participated in this survey, 84% were on prescribed psychoactive substances, with indicators of abuse in 28% of cases; more than half of these patients had also been using drugs of abuse (mainly cannabis) in the previous week. We then describe the main urological and renal toxicities of these drugs, in particular of heroin, cocaine, cannabis, ecstasy, LSD, amphetamine, new designer drugs, ketamine and opiate substitution treatment. We finally present a pharmaco-epidemiological survey of patients hospitalized for drugs complications in nephrology at the university hospital of Marseille. Between 2000 and 2015, 22 patients aged 18 to 57 years were hospitalized for renal adverse effects of drugs of abuse, such as glomerulonephritis, focal segmental glomerulosclerosis, acute kidney injury of chronic kidney disease. The somatic complications of drugs participate in their dangerousness and should be a red flag. They should be systematically reported to the addictovigilance national network to allow the improvement of information given to the patients and the medical community, and to adapt the prevention and risk reduction policies.

Biography

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Marion Gully is a resident in Nephrology at Aix-Marseille University, Marseille, France. She has been training in Nephrology and Infectious Diseases, where she took care of patients abusing drugs, some of whom had developped kidney damage. She became familiar with the French addictovigilance network and is now responsible for the reporting of renal adverse events of drugs of abuse in the department of Nephrology of Marseille University Hospital.