Scientists at the University of Alabama at Birmingham (UAB) published the first case studies linking synthetic marijuana use to acute kidney injury in the March, 2013, print edition of the Clinical Journal of the American Society of Nephrology. The authors reported that nephrotoxicity from synthetic cannabinoids in Spice or K2 should be considered in cases of acute kidney injury with no other evident cause and negative urine drug screens. Nephrotoxicity is a poisonous effect of a chemical or toxic substance on the kidneys (AKI Associated with Synthetic Cannabinoids_ A Case Series).

 

The case studies, led by senior author Denyse Thornley-Brown, M.D., associate professor in the UAB Division of Nephrology, identified four previously healthy young adults with acute kidney injury (AKI) as the result of synthetic cannbinoid ingestion. Three of the patients expierenced excretion of abnormally small volumes of urine while the fourth patient experienced a decrease in effective blood flow to the kidney. Each patient eventually recovered kidney function with none requiring dialysis.

 

The authors noted that the patients' common history of synthetic marijuana ingestion suggests a possible pathogenic role of the designer drug in the patients' AKI. The time of occurrence and close proximity of the cases also suggests a common toxic exposure. Due to the small sample size and inability to analyze the patients' bodily fluids or to obtain a sample of the synthetic marijuana involved, the researchers found it difficult to argue definitively for synthetic cannabinoids as a causative agent in acute kidney injury. The authors also could not rule out an additive in the synthetic marijuana as a cause since K2 or Spice preparations often contain several additives.

 

The authors recommended that doctors inquire about the use of designer drugs when evaluating patients with acute kidney injury, especially when the urine drug screen is negative and the causation is unknown. 

 

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