Spectrum of Acute Renal Injury Associated with MDMA (Ecstasy) or Other Party Drugs

Problems:

(1) The person may have ingested several types of stimulants.

(2) The drugs are synthetic and may be contaminated with unknown chemicals.

(3) The person may not know what they took or when.

The most common source of renal injury is non-traumatic rhabdomyolysis which can triggered by several mechanisms.

Other sources of renal injury may include:

(1) acute tubular necrosis (ATN) from other mechanisms (fever, dehydration, etc)

(2) toxic injury to the proximal renal tubules

(3) necrotizing vasculitis

(4) ischemic injury secondary to malignant hypertension

(5) obstructive uropathy

Determining the mechanism of renal injury can help to guide management and to aid in prognosis since some causes can permanently damage the kidneys. A renal biopsy may be necessary in some patients to make a diagnosis. Imaging studies may also be helpful especially if outflow obstruction is suspected.

If the party drugs that the person took are available then analysis of the drugs can be helpful. However, determining the drugs that the person took can be impossible.