Newer therapies and surgical management of ketamine-induced uropathy: A review.

Autor:	Katsiari T; Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK., Bae YE; Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK., Darlington Carbin Joseph D; Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK., Abou Chedid W; Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK., Moschonas D; Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK., Kusuma VRM; Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK., Patil K; Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK., Perry MJA; Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK.
Jazyk:	angličtina
Zdroj:	Urologia [Urologia] 2024 Feb; Vol. 91 (1), pp. 199-206. Date of Electronic Publication: 2023 Oct 28.
DOI:	10.1177/03915603231208094
Abstrakt:	Background and Aims: Ketamine use as a recreational drug is becoming more popular nowadays. Ketamine-induced uropathy (KIU) is a late finding observed with long-term use of ketamine. A systematic review of Ketamine-Induced Uropathy was performed to emphasise its key clinical manifestations, mechanism of action and establish an effective treatment pathway. Methods and Results: A literature search was conducted in MEDLINE via Pubmed and Cochrane using the keywords ketamine and bladder, ketamine and uropathy, and ketamine and epidemiology. The search strategy was limited to articles published from 2000 to 2023. Both animal and human studies were included. A total of 101 papers were reviewed based on topic relevance from the title and abstracts available. While ketamine is a controlled drug in the United Kingdom (UK) and other countries, 283 ketamine-related deaths have been reported in the UK. There is no definite pathogenesis but multiple potential mechanisms that cause KIU and its related symptoms. KIU involves chronic inflammation of the bladder, ureteral wall thickening, hydronephrosis and finally, chronic renal failure. A multidisciplinary approach is paramount when managing these patients to break the vicious cycle. The mainstay of medical and surgical treatment pathways is continued abstinence to prevent symptom relapse. This review included the pathophysiology, novel medical treatments and surgical management of KIU. Conclusion: KIU is a rare but significantly disabling condition often seen among ketamine abusers. With the rising trend in drug addiction, KIU is expected to be more common. Unfortunately, it is a late complication in chronic ketamine abusers and is only partially reversible even with abstinence. This review discusses this rare entity's newer medical treatments and surgical options. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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