The dangers of substance abuse in adolescents with chronic kidney disease: a review of the literature.
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Although there exist no specific data on the prevalence of substance abuse among children and adolescents with chronic kidney diseases (CKD), the magnitude of this problem should not be underestimated, as almost half of twelfth-graders in the U.S. admit to a history of using illegal drugs at least once when asked (National Institute on Drug Abuse, 2011). According to the 2010 Canadian Alcohol and Drug Use Monitoring Survey (Health Canada, n.d.), the prevalence of drug abuse among Canadian youths and young adults aged 15 to 24 remains higher than in adults older than 25 years of age, and the rates of drug use (excluding cannabis) in the past years were 7.9% and 0.8%, respectively, illustrating an almost 10 times higher rate in the younger age group (Health Canada, n.d.). Drug abuse can lead to numerous medical problems, including renal injury, and it is clearly a major public health concern, especially in patients with subnormal kidney function (Vupputuri et al., 2004). As most of the children and adolescents that suffer from CKD have long-term and trustful relationships with the nephrology team, we have the obligation and are in an excellent position to address this particular health issue (Finkelstein & Finkelstein, 2000; Kimmel, 2002; Kimmel, Cohen, & Peterson, 2008). This review summarizes the available data on the nephrotoxic effects of various commonly abused drugs with special emphasis on the additional damage that occurs in patients with pre-existing CKD. These data were obtained from a thorough search of the available primary literature, specifically using the PubMed database. The purpose is to provide health professionals with a resource to properly educate their CKD patients on the dangers of these drugs.
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