Introduction:

Cocaine is a natural sympathomimetic alkaloid derived from the Erythroxylum plant species of Central and South America. It is currently available in two forms: cocaine hydro­chloride (known as “coke”), which is a white powder, used intranasally, orally or intrave­nously and in a free-base form known as “crack” that is inhaled. Its stimulant properties have been known for a long time, originally through chewing the leaves or brewing them into a tea. Cocaine has even found its medical application in local anaesthetic solutions. Despite its natural origin and initial euphoric effect, the negative effects of cocaine on the human body are nume­rous.

Case description:

The case-report subject is a 23-year-old male admitted to a hospital Emergency Unit following a physical assault. Drug tests revealed traces of cocaine in the patient’s urine. His creatinine level was significantly elevated, while estimated glomerular filtration rate (eGFR) value significantly reduced, indicating potential renal complications due to kidney damage. Follow-up examinations during treatment revealed improvement in the patient’s renal status.

Commentary:

It confirms the harmful effects of cocaine on the kidneys through mechanisms like changes in renal haemodynamics, glomerular matrix synthesis and degradation, oxidative stress and induction of renal atherosclerosis. It also emphasises the importance of regular follow-up visits for patients after acute kidney injury due to possible complications.