Substance abuse has been increasing steadily in the UK and some other count
ries. Recent evidence suggests move than 40% of young people have tried ill
icit drugs at some time. There are numerous medical consequences to recreat
ional drug use, and a physician should always consider substance abuse in a
ny unexplained illness. The renal complications of drug abuse are also beco
ming more frequent, and may encompass a spectrum of glomerular, interstitia
l and vascular diseases. Although some substances are directly nephrotoxic,
a number of other mechanisms are also involved. These effects are often ch
ronic and irreversible, but occasionally acute with possible recovery. The
rapid growth of illicit drug use is clearly a major public health problem.
We review the commonly used substances of abuse and their associations with
renal disease.