Question-Synthetic cathenones (“bath salts”) are known to cause renal tubular injury. What is the likely mechanism for this form of kidney injury?
Answer- The cited reference reports “The tubular injury caused by bath salts is likely multifactorial. They inhibit reuptake of monoamines, including dopamine and norepinephrine, causing a surge in sympathetic activity. This may result in vasoconstriction and hypoperfusion of kidneys and muscles resulting in ATN and rhabdomyolysis. There may also be direct tubular cell toxicity from the bath salts or their metabolites, but this has not been specifically studied. (Nanavati A and Herlitz LC. Tubulointerstitial injury and drugs of abuse. 2017 Adv Chronic Kidney Dis 24(2):80-85).
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