Rhabdomyolysis after the Intake of Illicit Drugs as a Cause of Acute Renal Failure

Abstract

Background: Rhabdomyolysis (RM) is striate muscle-cell damage with the release of intracellular substances to the circulation—myoglobin, muscular enzymes, potassium, etc., with or without the development of acute renal injury. RM due to the intake of illicit and controlled substances, including cocaine, amphetamine and its derivates, cannabis, and alcohol abuse is a common cause of acute renal failure in adolescents and adults. Aim: to alert clinicians to the need of early diagnosis and treatment of RM due to the intake of controlled substances and energy drinks. Case Presentation: We describe a 20-year-old male patient with acute renal failure due to rhabdomyolysis after the intake of controlled substances, energy drinks, physical efforts and dehydration. The renal biopsy revealed acute tubular injury. After rehydration, alkalization, temporary dialysis treatment, intravenous corticosteroids and symptomatic treatment the patient restored renal function. Conclusion: RM can be a severe life-threatening complication of the intake of controlled substances combined with strenuous physical activity, energy drinks and dehydration. The described case represents a typical scenario of RM developing secondary to controlled substance abuse in combination with alcohol and strenuous physical activity. The prompt diagnosis and the timely initiation of supportive (rehydration and alkalization) and corticosteroid therapy and the early dialysis lead to fast resolution of renal failure. The clinicians should keep in mind illicit drugs, alcohol and energy drinks and physical efforts as possible triggers of RM and acute kidney injury, especially in young people.