Two Patients With Amphetamine-Induced Rhabdomyolysis Treated, One Dies

A 46-year-old man died following dialysis treatment after presenting with dark brown urine and severe muscle pain linked to amphetamine use, kormedi.com reported.

Key Clinical Takeaways:
• A 46-year-old male patient died during dialysis after exhibiting dark brown urine, muscle pain, and an extreme creatine kinase spike of 947,699 U/L, which is roughly 4,700 times the normal upper limit.
• A second reported case involving a 42-year-old male patient with similar symptoms and a positive amphetamine screen recovered after ten rounds of dialysis and was discharged with near-normal kidney function.

Amphetamines Cause Severe Muscle Breakdown and Kidney Failure

His urine appeared dark brown and diminished in volume. Laboratory examinations revealed a creatine kinase level of 947,699 U/L, sitting at approximately 4,700 times the upper limit of the normal 200 U/L range, according to kormedi.com.

Kidney function deteriorated rapidly alongside dangerous elevations in blood potassium and abnormal electrocardiogram readings. A urine drug screening returned a positive result for amphetamines. Medical personnel administered intravenous fluids alongside 11 sessions of hemodialysis. Although the muscle breakdown markers declined, renal function failed to recover. Computed tomography scans on the 28th day of hospitalization identified calcium deposits within the damaged muscle tissue, suggesting that accumulated calcium had re-entered the bloodstream. The patient suffered a cardiac arrest and died three days later.

Second Patient Recovers Kidney Function After Hemodialysis

A second patient detailed in the same medical report experienced comparable symptoms including severe myalgia, dark urine, and acute kidney injury at age 42. Testing confirmed amphetamine exposure via a positive urine screen. That patient underwent 10 hemodialysis treatments, after which clinical signs gradually improved, dialysis was discontinued, and kidney function returned to near-normal levels within one month of discharge, kormedi.com reported.

Pharmacological Mechanisms of Amphetamine Toxicity

Amphetamines act as powerful stimulants of the brain and central nervous system. Regulatory agencies classify them as controlled psychotropic substances, though they are prescribed clinically in certain jurisdictions to treat attention deficit hyperactivity disorder and narcolepsy. Misuse outside clinical supervision involves seeking enhanced concentration, elevated alertness, euphoria, or appetite suppression. The patients described in the study denied illicit drug use, leaving the exact timing, dosage, and formulation undetermined.

Medical literature notes that amphetamines can elevate body temperature, increase muscular activity, cause dehydration, and induce vasoconstriction, collectively triggering severe skeletal muscle breakdown known as rhabdomyolysis. This process releases the oxygen-storage protein myoglobin into the circulation. Myoglobin darkens the urine and obstructs the microscopic tubules within the kidneys, precipitating acute renal failure. Researchers publishing in the international journal Cureus emphasized that amphetamine-induced rhabdomyolysis remains an uncommon yet life-threatening medical emergency.

Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.