Chronic Kidney Disease from Polyvinylpyrrolidone Deposition in Persons with Intravenous Drug Use.
IVDU
chronic kidney disease
foreign material
intravenous drug use
macrophage storage
methadone
opioid addiction
tubular atrophy
Journal
Clinical journal of the American Society of Nephrology : CJASN
ISSN: 1555-905X
Titre abrégé: Clin J Am Soc Nephrol
Pays: United States
ID NLM: 101271570
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
received:
15
10
2021
accepted:
17
02
2022
pubmed:
18
3
2022
medline:
12
4
2022
entrez:
17
3
2022
Statut:
ppublish
Résumé
Persons with intravenous drug use have a higher risk of developing CKD compared with the general population. In Norway, deposits of polyvinylpyrrolidone have been observed in kidney biopsies taken from persons with opioid addiction and intravenous drug use since 2009. Polyvinylpyrrolidone is an excipient commonly used in pharmaceuticals, and the polyvinylpyrrolidone deposits observed in these patients were caused by intravenous injection of a specific oral methadone syrup containing very high molecular weight polyvinylpyrrolidone. Here, we present the clinicopathologic findings from 28 patients with CKD associated with polyvinylpyrrolidone deposition in the kidney. The 28 patients and their kidney biopsies were included when polyvinylpyrrolidone deposition was recognized, either retrospectively or at the time of diagnostic evaluation. Biopsies were taken between 2009 and 2016. We collected laboratory parameters and clinical data from digital patient charts. For each kidney biopsy, the glomerular volume, extent of polyvinylpyrrolidone deposition, and tubulointerstitial area with tubular atrophy were assessed quantitatively. All patients (mean age: 37 years) had CKD (mean eGFR: 33 ml/min per 1.73 m Intravenous injection of a specific oral methadone syrup caused polyvinylpyrrolidone deposition in the kidney in persons with opioid addiction and intravenous drug use. Kidney biopsy findings suggested an association between polyvinylpyrrolidone deposition and tubular atrophy.
Sections du résumé
BACKGROUND AND OBJECTIVES
Persons with intravenous drug use have a higher risk of developing CKD compared with the general population. In Norway, deposits of polyvinylpyrrolidone have been observed in kidney biopsies taken from persons with opioid addiction and intravenous drug use since 2009. Polyvinylpyrrolidone is an excipient commonly used in pharmaceuticals, and the polyvinylpyrrolidone deposits observed in these patients were caused by intravenous injection of a specific oral methadone syrup containing very high molecular weight polyvinylpyrrolidone. Here, we present the clinicopathologic findings from 28 patients with CKD associated with polyvinylpyrrolidone deposition in the kidney.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
The 28 patients and their kidney biopsies were included when polyvinylpyrrolidone deposition was recognized, either retrospectively or at the time of diagnostic evaluation. Biopsies were taken between 2009 and 2016. We collected laboratory parameters and clinical data from digital patient charts. For each kidney biopsy, the glomerular volume, extent of polyvinylpyrrolidone deposition, and tubulointerstitial area with tubular atrophy were assessed quantitatively.
RESULTS
All patients (mean age: 37 years) had CKD (mean eGFR: 33 ml/min per 1.73 m
CONCLUSIONS
Intravenous injection of a specific oral methadone syrup caused polyvinylpyrrolidone deposition in the kidney in persons with opioid addiction and intravenous drug use. Kidney biopsy findings suggested an association between polyvinylpyrrolidone deposition and tubular atrophy.
Identifiants
pubmed: 35296512
pii: 01277230-202204000-00009
doi: 10.2215/CJN.13681021
pmc: PMC8993479
doi:
Substances chimiques
Povidone
FZ989GH94E
Methadone
UC6VBE7V1Z
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
518-526Commentaires et corrections
Type : ErratumIn
Informations de copyright
Copyright © 2022 by the American Society of Nephrology.
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