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Article

Risk of Renal Function Decline in Patients with Ketamine-Associated Uropathy

1
Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
2
Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
3
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
4
Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(19), 7260; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17197260
Received: 8 August 2020 / Revised: 24 September 2020 / Accepted: 29 September 2020 / Published: 4 October 2020
(This article belongs to the Section Toxicology and Public Health)
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. View Full-Text
Keywords: hydronephrosis; ketamine-associated uropathy; renal function decline hydronephrosis; ketamine-associated uropathy; renal function decline
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MDPI and ACS Style

Ou, S.-H.; Wu, L.-Y.; Chen, H.-Y.; Huang, C.-W.; Hsu, C.-Y.; Chen, C.-L.; Chou, K.-J.; Fang, H.-C.; Lee, P.-T. Risk of Renal Function Decline in Patients with Ketamine-Associated Uropathy. Int. J. Environ. Res. Public Health 2020, 17, 7260. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17197260

AMA Style

Ou S-H, Wu L-Y, Chen H-Y, Huang C-W, Hsu C-Y, Chen C-L, Chou K-J, Fang H-C, Lee P-T. Risk of Renal Function Decline in Patients with Ketamine-Associated Uropathy. International Journal of Environmental Research and Public Health. 2020; 17(19):7260. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17197260

Chicago/Turabian Style

Ou, Shih-Hsiang, Ling-Ying Wu, Hsin-Yu Chen, Chien-Wei Huang, Chih-Yang Hsu, Chien-Liang Chen, Kang-Ju Chou, Hua-Chang Fang, and Po-Tsang Lee. 2020. "Risk of Renal Function Decline in Patients with Ketamine-Associated Uropathy" International Journal of Environmental Research and Public Health 17, no. 19: 7260. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17197260

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