Are bath salts and spice associated with Acute Kidney Injury?
Bath salts, which are cathinones, contain 3,4-methylenedioxypyrovalerone and 4-methylcathinone (mephedrone), which give users a feeling of euphoria, alertness, and increased sexual arousal.
Acute Kidney Injury is reported with bath salts, most often due to pigment-associated ATN in the setting of rhabdomyolysis.
It is unclear whether Acute Kidney Injuryresults from a direct nephrotoxic drug effect, pigment-related tubular injury, or an ischemic tubular insult. Spice is a synthetic cannabinoid with clinical presentations ranging from euphoria to psychosis.
The active ingredient, δ 9 THC, binds to the cannabinoid receptor 1 in the central nervous system, modulating GABAergic and glutaminergic transmission. While there is variability in the type of AKI syndromes, the majority is due to ATN.
Nearly 25% of Acute Kidney Injury patients may need temporary dialysis. Urine metabolites may damage kidney tubules and cause Acute Kidney Injury.
