Division of Nephrology, Department of Internal Medicine, University of Alabama, Birmingham, AL, USA.
Clin J Am Soc Nephrol. 2013 Apr;8(4):523-6. doi: 10.2215/CJN.05690612. Epub 2012 Dec 14.
SPICE, or K2, encompasses preparations of synthetic cannabinoids marketed as incense products, bath additives, and air fresheners and used for recreational purposes. These preparations are usually smoked for their cannabis-like effects and do not appear on routine urine toxicology screens. We report four cases of oliguric AKI associated with SPICE use in previously healthy men. All showed improvement in renal function without need for renal replacement therapy. Renal biopsy, performed in three of the patients, revealed acute tubular necrosis. The close temporal and geographic associations between the clinical presentation and the development of AKI strongly suggest an association between these SPICE preparations and AKI. Further investigations are required to identify the potential nephrotoxic agent(s). Nephrotoxicity from designer drugs should be included in the differential diagnosis of AKI, especially in young adults with negative urine drug screens.
SPICE（或 K2）是指以熏香产品、浴盐添加剂和空气清新剂形式出售的合成大麻素制剂，被人们用于娱乐目的。这些制剂通常通过吸烟来获得类似大麻的效果，而且不会出现在常规尿液毒理学筛查中。我们报告了 4 例与 SPICE 使用相关的少尿性急性肾损伤（AKI），这些患者都是先前健康的男性。所有患者的肾功能均有所改善，无需进行肾脏替代治疗。对其中 3 例患者进行的肾活检显示为急性肾小管坏死。临床表现与 AKI 发生之间的密切时间和地域关联强烈提示这些 SPICE 制剂与 AKI 之间存在关联。需要进一步研究以确定潜在的肾毒性物质。对于 AKI，尤其是在尿液药物筛查阴性的年轻成年患者，应将来自设计药物的肾毒性纳入鉴别诊断。
