INTRAVENOUS DRUG-USE AND GLOMERULAR DEPOSITION OF LIPID-LIKE MATERIAL

We present a series of 5 intravenous drug users (4 male, age range 24- 47 years) with glomerular deposition of a lipid-like material. Three p atients presented with the nephrotic syndrome, 1 with acute renal fail ure and 1 with hypertension and an active urinary sediment. All were c ontinuing to use opiates intravenously (mixed with lemon juice or acet ic anhydride and sodium bicarbonate). Investigations: plasma creatinin e 0.10-0.30 mmol/l, urinary protein excretion 1.0-6.75 g/24 h, hepatit is C antibody positive (4), all seronegative for hepatitis B and HIV. Renal biopsy showed large vacuolated areas consistent with heavy depos ition of lipid-like material in all glomerular cells and infiltrating macrophages, Two showed ATN and another FGS, We suggest that these cha nges are due to the pattern of illicit drug availability and preparati on peculiar to these users.