Acute Kidney Injury (AKI) in Young Synthetic Cannabinoids Abusers

Abstract

Background. Synthetic cannabinoid-related acute kidney injury represents an increasingly important public health issue due to the diagnostic challenges given by low clinical suspicion of the disease and the frequent undetectability in routine drug tests. Methods. A systematic literature search on PubMed was carried out until 31 January 2022. Case reports, case series, retrospective and prospective studies, as well as reviews on acute kidney injury related to the consumption of synthetic cannabinoid were searched. Results. The systematic review process selected 21 studies for a total of 55 subjects with synthetic cannabinoid-induced acute kidney injury. Renal damage was demonstrated by elevated serum creatinine levels in 49 patients (89%). On renal ultrasound, the most frequent finding was an increase in cortical echogenicity. Renal biopsy, performed in 33% of cases, revealed acute tubular damage, acute tubulointerstitial nephritis, and acute interstitial nephritis, in decreasing order of frequency. Conclusion. Prompt identification and treatment of synthetic cannabinoid-related acute kidney injury represent a sensitive public health goal both for the acute management of damage from synthetic cannabinoids and for the prevention of chronic kidney disease.

Keywords: acute kidney injury; acute tubular damage; intoxication; synthetic cannabinoids.

Figure 1

Flow chart of the systematic literature search according to PRISMA 2020 guidelines.

Figure 2

Age distribution of synthetic cannabinoid-induced acute kidney injury.

Figure 3

Clinical presentation of synthetic cannabinoid intoxication.

Figure 4

Histological findings on renal biopsy.

Figure 5

Causality assessment through Naranjo Adverse Drug Reaction Probability Scale.