Renal and Urinary System Issues Caused by Substance Abuse

In addition to their association with substance use disorders and addiction, problematic drug and alcohol use can have several adverse effects on the renal (kidney) and urinary system. This page will give an overview of the renal and urinary system, how it may be affected by a variety of substances, and how to find help for addiction.

What Is the Renal and Urinary System?

The renal and urinary system includes the kidneys, ureters, bladder, and urethra.1 Together, this organ system plays an important, life-sustaining filtration and detoxifying role—helping to remove metabolic waste products and foreign substances through urinary excretion. 1

In addition to filtering your blood, the kidneys perform other vital functions, including:1

  • Regulating serum osmolality, electrolytes, and acid-base balance.
  • Maintaining proper fluid balance and blood pressure.
  • Producing a hormone that plays a role in red blood cell production.
  • Converting vitamin D to its active form.

With such a range of important functions, the kidneys play an indispensable role in maintaining a healthy body.

Which Drugs Affect Your Kidneys?

Many types of substances are associated with certain types of kidney injury and other potential renal issues, including:2,3

  • Opioids.
  • Cocaine.
  • Nicotine.
  • Alcohol.
  • Synthetic cannabinoids (Spice).
  • MDMA/Ecstasy.
  • Ketamine.
  • Methamphetamine.
  • Benzodiazepines.

Impact of Substance Use on Your Renal System

Renal complications of substance use include a range of glomerular, renal interstitial, and vascular pathologies. Some drug-related renal injuries are acute and reversible, though others can be more severe, and progress to end stage kidney failure—a situation which may require long-term hemodialysis or kidney transplant.2,4

What follows is an overview of how each substance can potentially impact the renal and urinary system.

Opioids and Kidney Issues

Opioids can lead to a wide variety of short- and long-term kidney problems. Chronic opioid use is associated with potentially severe renal complications due to structural and functional changes within the kidneys.

Examples include progressive inflammation of delicate kidney tissues, various molecular deposition issues that hinder filtration, and overdose-related rhabdomyolysis (which can lead to kidney failure).2,5

Renal Injuries and Cocaine

Cocaine is capable of causing both acute and chronic renal injury. Though rare, cocaine use is associated with renal infarction, which cuts off blood flow to parts of the kidney (causing a “stroke” in the kidney).

Additional issues include electrolyte imbalances, interstitial nephritis, and rhabdomyolysis-related kidney injury.6,7

Potential Effects of Nicotine on the Renal System

Nicotine use through smoking is well known to hasten the progression of renal failure to end-stage renal disease. As it is cleared from the blood through the kidneys, high levels of nicotine and its metabolites may result in direct toxicity of the delicate renal filtration system.2

Impact of Alcohol on Kidney Function

Alcohol may impair kidney function in association with interstitial swelling (edema) and enlargement of the kidney, increasing the risk acute renal failure in association with kidney infection (pyelonephritis), and making your kidney more vulnerable to damage from other medications or existing kidney disease.

Chronic alcohol use is also associated with kidney-related electrolyte disturbances and fluid imbalance.2

Synthetic Cannabinoids and Renal Injury

Synthetic cannabinoids (Spice) have been implicated in several case reports with acute kidney injury which, in some cases, included acute renal tubular necrosis and interstitial nephritis. Some cases were associated with kidney damage severe enough to require dialysis.8

How Ecstasy Can Affect the Renal and Urinary System

MDMA/ecstasy and related compounds may cause your hypothalamus to secrete antidiuretic hormone, or ADH—a hormone that influences renal water reabsorption, essentially discouraging your body from making urine.8

In combination with increased thirst, in a hot and physically active environment, people using ecstasy often drink much more water than usual. Because your body can’t make urine, the extra fluid builds up and disrupts normal sodium levels in the blood, which can have life-threatening consequences (e.g., mental status changes, brain swelling, seizures, etc.).8

Ecstasy-associated acute kidney injury has also been reported in cases of intoxication-related rhabdomyolysis.8

Inhalant Drugs and Kidney Damage

Various household products such as glues, cleaning fluids, and paint products may contain chemicals that increase the risk of renal toxicity. Certain types of inhalant use have been linked with long-term kidney damage.3

Ketamine’s Impact on the Bladder, Urinary Tract, and Kidneys

Ketamine use has been associated with acute kidney injury secondary to ketamine-induced uropathy. The bladder is commonly affected, and symptoms may first appear similar to those of a urinary tract infection, inflammation of the bladder (i.e., cystitis), overactive bladder syndrome (urinating more often), and bladder pain syndrome.9

Methamphetamine and Kidney Failure

Methamphetamine use is associated with rhabdomyolysis, which can directly lead to acute kidney failure.10 Other kidney damage associated with meth use includes acute cortical necrosis (outer kidney tissue death), necrotizing vasculitis (blood vessel wall inflammation), and mesangiocapillary glomerulonephritis (a kidney disorder that may cause blood in urine.)11,12

Benzodiazepines and Renal Issues

Benzodiazepines may also be associated with rhabdomyolysis, thus putting you at risk for acute kidney failure.10,13

Get Help for Drug and Alcohol Addiction at Sunrise House

Substance use can lead to a variety of unintended health consequences. If you or a loved one are struggling with addiction, Sunrise House Treatment Center—a rehab in Lafayette, NJ,—may be able to help.

A premier addiction treatment center, Sunrise House employs evidence-based addiction therapy to treat substance use and co-occurring disorders. Whether medical detox addiction treatment or residential/inpatient rehab is right for you, treatment programs are customized to meet your individual needs.

Caring admissions navigators are available 24/7 to answer your questions on rehab admissions, rehab payment options, and more. Does your insurance cover rehab? Sunrise House makes it easy to .

Start your journey to recovery today. Call Sunrise House Treatment Center at .

Was this page helpful?
Thank you for your feedback.

American Addiction Centers (AAC) is committed to delivering original, truthful, accurate, unbiased, and medically current information. We strive to create content that is clear, concise, and easy to understand.

Read our full editorial policy

While we are unable to respond to your feedback directly, we'll use this information to improve our online help.

You aren't alone. You deserve to get help.
Take the first step toward recovery at New Jersey’s premier drug rehab and treatment center. Located just an hour outside Manhattan, Sunrise House can help you find peace and healing—away from the hustle and bustle of city life.