Cocaine and the kidney: A synthesis of pathophysiologic and clinical perspectives

Cocaine abuse has reached epidemic proportions in the United States, and se veral forms of renal disease have been associated with this widespread use. The hemodynamic actions of cocaine, as well as its effects on matrix synth esis, glomerular inflammation, and glomerulosclerosis, may contribute to re nal injury. Cocaine abuse has been associated with various forms of acute r enal failure and acid-base and/or electrolyte disorders and may also have a role in the progression of chronic renal failure to end-stage renal diseas e. In utero exposure to cocaine has been associated with urogenital tract a nomalies. Medical management of a hypertensive emergency caused by acute co caine toxicity requires a multisystem approach, with close monitoring of ca rdiac, neurological, and renal functions. (C) 2000 by the National Kidney F oundation, Inc.