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Estimated annual dialysis cost for just one person who has wrecked his own kidneys by shooting heroin ("heroin nephropathy"): $50,000
Source: A paraphrase from the AMERICAN JOURNAL OF KIDNEY DISEASES, 40(3):611-622, Lee H © 2002 National Kidney Foundation.
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Some drugs may cause kidney damage or failure, either directly or indirectly from dangerous increases in body temperature and muscle breakdown.
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| Selected Research Findings on the Mental Health Effects of Drug Abuse |
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End-Stage Renal Disease and Chronic Kidney Disease in a Cohort of African-American HIV-Infected and At-Risk HIV-Seronegative Participants Followed between 1988 and 2004
HIV-infected African-Americans are at increased risk of end-stage renal disease requiring renal replacement therapy (RRT). This study sought to compare the incidence of RRT in a cohort of 4509 HIV-infected and 1746 HIV-seronegative African-Americans and describe temporal trends in RRT and chronic kidney disease (CKD) in HIV infection. Incident RRT was defined by matching participant identifiers with the US Renal Data System; CKD was defined as an estimated glomerular filtration rate < 60 ml/min per 1.73m for >/= 3 months. Standardized incidence ratios (SIR) and 95% confidence intervals (CI) were calculated by indirect adjustment. Risk factors for RRT were assessed by person-time methods and Poisson regression. RRT was initiated in 24 HIV-seronegative subjects over 13415 person-years of follow-up (SIR, 2.3; 95% CI, 1.5-3.4), in 51 HIV-infected participants without AIDS over 10780 person-years (SIR, 6.9; 95% CI, 5.1-9.0), and in 125 participants with AIDS over 9833 person-years. SIR, 16.1; 95% CI, 13.4-19.2). In HIV-infected African-Americans, RRT incidences were 5.8 and 9.7/1000 person-years in the pre-HAART and HAART eras, respectively (adjusted rate ratio 1.2; 95% CI, 0.8-1.9). In supplementary analyses, CKD incidence declined significantly in the HAART era compared with pre-HAART, but the CKD period prevalence increased. Nearly 1% of HIV-infected African-Americans initiated RRT annually, a rate that was similar in the HAART and pre-HAART eras. However, while new cases of CKD decreased, the prevalence of CKD increased in the HAART era. This increase reflects improvements in survival among individuals with HIV-associated CKD. Lucas, G., Mehta, S., Atta, M., Kirk, G., Galai, N., Vlahov, D., and Moore, R. End-Stage Renal Disease and Chronic Kidney Disease in a Cohort of African-American HIV-Infected and At-Risk HIV-Seronegative Participants Followed between 1988 and 2004. AIDS, 21(18), pp. 2435-2443, 2007.
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