Mirza Sazan A, Mohammed Nawar S, Ali Zahraa Q, Mohamed Aseel Sameer
Department of Pathology, College of Medicine, University of Baghdad, Baghdad, Iraq.
Department of Biochemistry, College of Medicine, University of Baghdad, Baghdad, Iraq.
Toxicol Rep. 2025 Jun 6;14:102065. doi: 10.1016/j.toxrep.2025.102065. eCollection 2025 Jun.
Methamphetamine (METH), a synthetic derivative of amphetamine, is prescribed for disorders such as narcolepsy but is sometimes illicitly produced from over-the-counter drugs like pseudoephedrine to produce "crystal meth." Consumption of METH can have a severe impact on a number of organ systems, including renal failure, neurotoxicity, pulmonary toxicity, and cardiotoxicity. Increased doses of METH can elevate blood pressure and heart rate, hence enhancing the chance of serious repercussions. Acute renal failure associated with METH is linked to kidney issues such as renal tubular necrosis, caused by reduced blood flow, and acute interstitial nephritis, which damages kidney tubules and impairs waste filtration. Biomarkers such as elevated serum levels of urea, creatinine, cystatin C, and neutrophil gelatinase-associated lipocalin (NGAL) indicate acute kidney injury (AKI). METH-induced renal failure often correlates with hyperthermia, hemodynamic instability, rhabdomyolysis, and nephropathies like necrotizing angiitis, tubular necrosis, and interstitial nephritis. This study investigates the association between kidney toxicity and AKI in Iraqi males with METH addiction. The research, carried out at Ibn-Rushed Psychiatric Hospital in Baghdad between January and August 2023, involved 168 males aged 22-43 who had been addicted for over 60 months. Additionally, 154 healthy males with no history of drug use served as controls. Drug test screening cards were utilized to confirm the diagnosis. Kidney function tests (urea, creatinine), total protein, serum albumin, sodium ions, cystatin C, creatine kinase, and NGAL levels were assessed. Results revealed significant differences between addicts and controls, particularly elevated cystatin C, creatine kinase, and NGAL levels in addicts. A ROC curve analysis demonstrated heightened sensitivity of kidney function tests to METH-induced renal damage. Histopathological examination of a deceased male, aged 41-year-old, with a seven-year history of METH abuse revealed evidence of acute kidney injury, accompanied by significantly elevated levels of renal function biomarkers. The findings suggest that prolonged methamphetamine use may have contributed to severe renal impairment, manifesting in both structural damage to the kidneys and a marked disruption in renal function. This study highlights the severe impact of METH on kidney function and underscores the importance of preventive measures and effective treatment strategies for managing METH addiction and mitigating its harmful effects.
甲基苯丙胺（METH）是苯丙胺的一种合成衍生物，被用于治疗发作性睡病等疾病，但有时也会从伪麻黄碱等非处方药非法制造出来以生产“冰毒”。服用METH会对多个器官系统产生严重影响，包括肾衰竭、神经毒性、肺毒性和心脏毒性。METH剂量增加会升高血压和心率，从而增加严重不良反应的几率。与METH相关的急性肾衰竭与肾脏问题有关，如因血流量减少导致的肾小管坏死，以及损害肾小管并影响废物过滤的急性间质性肾炎。诸如血清尿素、肌酐、胱抑素C和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平升高之类的生物标志物表明存在急性肾损伤（AKI）。METH诱发的肾衰竭通常与体温过高、血流动力学不稳定、横纹肌溶解以及诸如坏死性血管炎、肾小管坏死和间质性肾炎等肾病相关。本研究调查了伊拉克甲基苯丙胺成瘾男性的肾脏毒性与急性肾损伤之间的关联。该研究于2023年1月至8月在巴格达的伊本·鲁世德精神病医院开展，涉及168名年龄在22至43岁之间、成瘾超过60个月的男性。此外，154名无吸毒史的健康男性作为对照。使用药物检测筛查卡来确诊。评估了肾功能测试（尿素、肌酐）、总蛋白、血清白蛋白、钠离子、胱抑素C、肌酸激酶和NGAL水平。结果显示成瘾者与对照之间存在显著差异，尤其是成瘾者的胱抑素C、肌酸激酶和NGAL水平升高。ROC曲线分析表明肾功能测试对METH诱发的肾损伤具有更高的敏感性。对一名41岁、有七年甲基苯丙胺滥用史的已故男性进行的组织病理学检查显示有急性肾损伤的迹象，同时肾功能生物标志物水平显著升高。研究结果表明，长期使用甲基苯丙胺可能导致严重的肾功能损害，表现为肾脏结构损伤和肾功能明显紊乱。本研究突出了METH对肾功能的严重影响，并强调了预防措施以及有效治疗策略对于管理甲基苯丙胺成瘾和减轻其有害影响的重要性。
