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Case report
Methamphetamine (N-methylamphetamine)-induced renal disease: underevaluated cause of end-stage renal disease (ESRD)
  1. Krishna M Baradhi1,
  2. Samata Pathireddy2,
  3. Subhasish Bose3,4 and
  4. Narothama Reddy Aeddula5,6
  1. 1 Nephrology, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, USA
  2. 2 Internal Medicine, Deaconess Health System, Evansville, Indiana, USA
  3. 3 Nephrology, Lynchburg Nephrology, Lynchburg, Virginia, USA
  4. 4 Medicine, University of Virginia, Charlottesville, Virginia, USA
  5. 5 Medicine, Deaconess Health System, Evansville, Indiana, USA
  6. 6 Medicine, Indiana University School of Medicine, Evansville, Indiana, USA
  1. Correspondence to Dr Samata Pathireddy, drspathireddy{at} and Dr Narothama Reddy Aeddula, nareddy{at}


A 26-year-old Caucasian man with no medical history, except years of oral and intravenous drug abuse, presented with fatigue, shortness of breath, epistaxis and uncontrolled hypertension. He was pale with skin ecchymosis over his thighs and was anaemic, with severe renal failure and metabolic acidosis. Following initial clinical stabilisation of the patient, a renal biopsy was obtained, which showed vascular and glomerular changes consistent with thrombotic microangiopathic injury and advanced glomerulosclerosis. He was treated with antihypertensives and required haemodialysis. He admitted using ‘crystal meth’ regularly for many years, which is likely responsible for his renal failure. We present the case to illustrate methamphetamine-induced renal disease leading to end-stage renal disease and to bring awareness among practising clinicians, ancillary healthcare workers and public health professionals of this often undervalued cause of renal failure, which can be prevented.

  • drug misuse (including addiction)
  • unwanted effects / adverse reactions
  • public health
  • chronic renal failure

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  • Contributors KMB was involved in the planning; conception; acquisition of data, including images; and patient consent. KMB, NRA, SP and SB helped with the literature search and final drafting of the case report. KMB and NRA are the first authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.