Recreational drug use: A neglected risk factor for end-stage renal disease

Case series have suggested that heroin and cocaine users are at increased r isk for renal failure, but the contribution of heroin and other addictive d rugs to the incidence of end-stage renal disease (ESRD) in the general popu lation remains unknown. To clarify this issue, we conducted a case-control study in the general population to examine associations between drug use an d treated ESRD, Cases were 716 patients who started therapy for ESRD in 199 1, identified through a regional registry. Controls were 361 persons of sim ilar age (20 to 65 years) selected by random digit dialing. Main risk facto rs examined were the lifetime use of heroin, cocaine, and other addictive d rugs, assessed by telephone Interview. After adjustment for age, sex, race, socioeconomic status, and history of hypertension and diabetes, persons wh o had ever used heroin or other opiates (any amount) were at increased risk for ESRD (adjusted odds ratio, 19.1; 95% confidence interval, 1.7 to 208.7 ). After adjustment for the same sociodemographic and medical history varia bles, the use of cocaine or crack and psychedelic drugs was also associated with ESRD, but these associations could not be separated from the effects of heroin use. (C) 2001 by the National Kidney Foundation, Inc.