Nowadays, drug abusedisone ofthe major health concern in society. According to the clinical observations, the prevalence of addiction to a new psychoactive drug is increased among the adolescense and youth. Amphetamine (AMPs) is used as a recreational drug to bring the sense of energy and euphoria for its user. Amphetamine may cause hepatotoxicity, rhabdomyolysis, cardiotoxicity, nephrotoxicity, and neurotoxicity separately or sometimes together as multiorgan toxicity, mostly as a serious condition which is required hospitalization. In the beginning of end-stage renal disease, substance related renal disease has been involved in 5-6% patients. Case report. A 24-years-old man came to the hospital escorted by a security from a night club with unconsciousness, he reported that the patient consumed alcohol along with a green pill, while the name of the drug and the quantity remained unknown. Right after he took the drug, his reaction was jumping followed by vomitting then he fell unconscious before he had seizures for 5 minutes. Physical examination,we found the patient unconscious, fever presented at 40,50C, the blood pressure was 90/55 mmHg,and heart rate was 160 times per minutes, also respiratory rate was 26 times per minutes and room air oxygen saturation was 98%. From blood examination, we found Hb level 17 gr / dl, WBC 19.37 × 103sel / mm3, platelets183.000 cells / mm3, BUN 34 mg / dL, creatinine serum 3.86 mg / dL, sodium 137 mmol / L, potassium 3.11 mmol / L. total bilirubin 7.91 mg / dL, direct bilirubin 7.18 mg / dL, indirect bilirubin 0.73 mg / dL, AST 191,3 U / L, ALT 56.7 U / L, elevated prothrombine time 32 second, CKMB >40 ng/ml, T-troponin was high (732 ng/ml). Blood gas analysis revealed metabolic acidosis (pH 7.31, HCO3 17.7 mmol/L, BE -8.5 mmol/L, pCO2 36.1 mmHg). Urinalysis showed proteinuria (100 mg/dl), erythrocyturia (+3), urine amphetamin was positive, marijuana and morphine were negative. Urine output was 100 cc/24 hours. We diagnosed the patient with acute kidney injury (AKI) stage 3 due to AMPs intoxication with unstable haemodynamic. Initial management was fluid and electrolyte resuscitation, 8 sessions of daily SLED hemodialysis were performed,continue with alternate day HD. After 14 days hospitalization, blood result showed increase of BUN 50 mg/dl, serum creatinine was 7.1 mg/dl, a metabolic acidosisf rom blood gas analysis then death occured after mechanical ventilator was used to improve respiratory failure. Amphetamines represent a class of psychotropic compounds, widely abused for their stimulant, euphoric, anorectic, and in some cases, emphathogenic, entactogenic, and hallucinogenic properties. Renal complication as result of AMPs use are associated with hyperpyrexia and fibrinolysis (disseminated intravascular coagulation; DIC). Also, microvascular obstruction secondary to DIC, myoglobinuria, systemic hypotension or hyperpyrexia may lead to acute renal failure which is generally presents as AKI, hyponatremia, and hypertension Figure 1. Gross haematuriaView Large Image Figure ViewerDownload Hi-res image Download (PPT)Figure 2. Hypertermia patient A 24-years-old man came with AKI due to amphetamine intoxication. Initial management was fluid and electrolyte resuscitation, and 13 sessions of HD. Deterioration of conditions and death occured due to multiorgan failure.