Acute kidney injury associated with smoking synthetic cannabinoid. Buser GL et a. Clin Toxicol 2014;52:663-673.
In the summer of 2012, two patients presented to emergency departments in western Oregon complaining of nausea, vomiting and flank pain that started shortly after smoking a synthetic cannabinoid product. Both patients had elevated serum creatinine levels and hypertension. Renal biopsy revealed acute tubular injury with inflammation in both patients. Extensive work-up did not reveal any other possible cause of renal disease.
A public health investigation identified seven other patients in the region who presented with acute kidney injury (AKI) within 2 weeks of smoking a synthetic cannabinoid. Some key features of these cases include:
- Exposure to several synthetic cannabinoid products, including “Clown Loyal,” Johnny Clearwater” (caramel corn), “Lava,” and “Orgazmo” (pineapple).
- The synthetic cannabinoid XLR-11 was detected in each of 2 involved products that were tested, as well as in clinical specimens from one of five patients tested.
- All patients recovered, although received a short course of hemodialysis.
This article is a very complete and finely done description both of the clinical syndrome of AKI associated with use of synthetic cannabinoids, and the related public health investigation. [HT @DougBorys]