ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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JMBS 2021, 6(3): 14–21
Medicine. Reviews

Acute and Chronic Kidney Injury due to the Influence of Opioids. Literature Review

Vilkhova I. V.

Acute kidney injury is the cause of death for about 2 million people a year worldwide and often leads to the development of chronic renal failure. Use of opioids is one of the reasons of acute and chronic kidney injuries. Most drugs or their metabolites are excreted by the kidneys and lead to the changes of the structure and functions of this organ. Drug abuse is a social problem in the modern world and the use of opioids in treatment of chronic pain syndrome is common in medical practice, because of this, knowledge of the mechanisms of kidney injury under the influence of opioids is important in medical practice. Compliance of morphological changes in kidneys to the severity of clinical syndrome of decreased glomerular filtration rate and the level of biochemical markers due to acute kidney injury and chronic renal disease remains relevant. Causes of acute kidney injury while using opioids may be renal ischemia as a result of decreased glomerular filtration rate, hypotension, dehydration and also rhabdomyolysis and acute urinary retention. It is shown that one of the causes of renal ischemia while using the opioids is increased influence of parasympathetic nervous system and decreased influence of sympathetic nervous system. Usage of opioids indirectly inhibits renin-angiotensin-aldosterone system through the changes of catecholamines. The influence of opioids on synthesis of antidiuretic hormone was established, namely – usage of opioids leads to the decreased secretion of antidiuretic hormone, and as a result – to increased diuresis. Presented review of literature was used for analysis of pathogenic factors, biochemical changes and morphological forms of kidney ingury due to the usage of opioids. Sources which were used include studies of morphofunctional changes of kidneys of those who had drug addiction and those who used opioids for a long time because of medical reasons. The results of experimental studies of the structure and function of the kidneys under the opioid influence are also presented. The morphological forms of kidney injury under the action of the most commonly used opioids, in particular morphine, cocaine, heroin, were analyzed. The data of investigation of pathogenetic links of acute and chronic kidney injuries and biochemical deviations that are common for disturbance of functions of kidneys under the influence of opioids are presented. This review can be used for experimental works related to the study of the mechanisms of kidney damage under the influence of opioids, as well as in the treatment of kidney pathology of drug addicts and people who used opioids for a long time due to medical reasons

Keywords: kidneys, morphology, opioids, damage

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