Abstract
Ketamine-associated diseases have been increasing with the rise in ketamine abuse. Ketamine-associated uropathy is one of the most common complications. We investigated the effects of ketamine-associated uropathy on renal health and determined predictors of renal function decline in chronic ketamine abusers. This retrospective cohort study analyzed 51 patients (22 with ketamine-associated hydronephrosis and 29 with ketamine cystitis) from Kaohsiung Veterans General Hospital in Taiwan. Primary renal outcome was end-stage renal disease or estimated glomerular filtration rate decline >30% from baseline. Compared with the ketamine cystitis group, the hydronephrosis group had lower initial and final estimated glomerular filtration rates and higher alkaline phosphatase and gamma-glutamyl transferase levels (p < 0.05). Elevated cholestatic liver enzyme levels correlated with renal dysfunction in ketamine-associated uropathy. The hydronephrosis group had a higher proportion of patients reaching endpoints than the ketamine cystitis group (50% and 7%, respectively, p < 0.001). After adjusting for age, sex, and initial serum creatinine level, hydronephrosis remained an independent risk factor for renal function deterioration. Ketamine-associated hydronephrosis was a poor renal outcome and strong predictor of renal function decline in chronic ketamine abusers. Elevated cholestatic liver enzyme levels correlated with the severity of ketamine-associated uropathy. Ultrasonography screening of these high-risk groups and regular renal function follow-ups are necessary.
Highlights
Ketamine, a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist, was first synthesized in the United States in 1962
The included patients were categorized into two groups as follows: patients with ketamine-associated hydronephrosis and patients with only ketamine cystitis
51 patients classified into the ketamine-associated hydronephrosis (n = 22) and ketamine cystitis (n = 29) groups were included in this study
Summary
A non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist, was first synthesized in the United States in 1962. Since it has been widely used as an anesthetic and analgesic agent in human and animal medicine. It has been widely used as an anesthetic and analgesic agent in human and animal medicine It has been adopted as an agent in the treatment of major depression, treatment-resistant depression, and bipolar affective disorder [1,2]. Ketamine abuse has become a problem of serious social concern with increasing prevalence due to its highly addictive nature. The reported events of ketamine abuse in Taiwan have increased from
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