Dunea G, Arruda J A, Bakir A A, Share D S, Smith E C
Division of Nephrology, Cook County Hospital, Chicago, IL 60612.
Am J Nephrol. 1995;15(1):5-9. doi: 10.1159/000168794.
During a period of 1 year we observed 12 African American patients who had smoked or sniffed cocaine for several years and presented to inner city hospitals with accelerated hypertension and renal insufficiency. Ten required maintenance dialysis; 1 recovered partially after a brief period of dialysis, and 1 had moderate renal insufficiency. In the absence of striking proteinuria, cardiomegaly or renal shrinkage, the probable diagnosis in most of the patients was primary accelerated hypertension. The clinical history suggested that the habitual use of cocaine had worsened the hypertension, made it more difficult to control or triggered an accelerated phase resulting in renal shutdown. At a time when billions of dollars are being spent on the treatment of end-stage renal disease, the harmful role of cocaine in susceptible individuals requires due attention.
在1年的时间里，我们观察了12名非裔美国患者，他们多年来一直吸食或鼻吸可卡因，并因高血压加速和肾功能不全而被送往市中心医院。10人需要维持性透析；1人在短期透析后部分恢复，1人有中度肾功能不全。由于没有明显的蛋白尿、心脏肥大或肾脏萎缩，大多数患者的可能诊断是原发性高血压加速期。临床病史表明，习惯性使用可卡因使高血压恶化，使其更难控制或引发加速期，导致肾功能衰竭。在花费数十亿美元治疗终末期肾病之际，可卡因对易感个体的有害作用需要引起应有的关注。
