Daño renal inducido por el uso de cannabis, cocaína, estimulantes de tipo anfetamínico, heroína y nuevas sustancias psicoactivas (cannabinoides sintéticos y catinonas sintéticas): una revisión exploratoria de la literatura 2015- 2026

Abstract

La lesión renal inducida por sustancias psicoactivas representa un problema clínico heterogéneo por la variedad de mecanismos y presentaciones asociadas al consumo de cannabis, cocaína, estimulantes tipo anfetamínico, heroína, cannabinoides sintéticos y catinonas sintéticas. Esta scoping review, desarrollada entre 2015 y 2026 con enfoque PCC y lineamientos JBI, tuvo como objetivo mapear la evidencia sobre mecanismos de daño renal, manifestaciones clínicas, biomarcadores y fenotipos renales vinculados a estas sustancias. Se incluyeron estudios primarios de cualquier diseño, además de revisiones narrativas y sistemáticas, en español o inglés, siempre que el texto completo pudiera evaluarse; se excluyeron trabajos anteriores a 2015, estudios sin datos separables por sustancia, reportes sin respaldo empírico y estudios en animales sin correlato humano. El alcance conceptual abarcó lesión renal aguda, enfermedad renal crónica, glomerulopatías, nefritis intersticial, microangiopatía trombótica, proteinuria, hematuria, cilindruria y biomarcadores como NGAL y KIM-1. La revisión también organiza los principales mecanismos fisiopatológicos descritos en la literatura, incluyendo inflamación e inmunidad, alteraciones hemodinámicas intraglomerulares, toxicidad tubular, nefropatía por cristales, rabdomiólisis y microangiopatía trombótica. En conjunto, el documento busca aportar una síntesis útil para delimitar patrones de daño renal por sustancias psicoactivas y orientar futuras investigaciones en nefrología y adicciones. Substance-induced kidney injury presents a heterogeneous clinical problem due to the variety of mechanisms and presentations associated with the use of cannabis, cocaine, amphetamine-like stimulants, heroin, synthetic cannabinoids, and synthetic cathinones. This scoping review, conducted between 2015 and 2026 using a PCC approach and JBI guidelines, aimed to map the evidence on mechanisms of kidney damage, clinical manifestations, biomarkers, and renal phenotypes linked to these substances. Primary studies of any design were included, as well as narrative and systematic reviews, in Spanish or English, provided the full text could be assessed. Studies published before 2015, studies without separable data by substance, reports without empirical support, and animal studies without human correlates were excluded. The conceptual scope encompassed acute kidney injury, chronic kidney disease, glomerulopathies, interstitial nephritis, thrombotic microangiopathy, proteinuria, hematuria, cylindruria, and biomarkers such as NGAL and KIM-1. The review also organizes the main pathophysiological mechanisms described in the literature, including inflammation and immunity, intraglomerular hemodynamic alterations, tubular toxicity, crystal nephropathy, rhabdomyolysis, and thrombotic microangiopathy. Overall, the document aims to provide a useful synthesis for defining patterns of kidney damage caused by psychoactive substances and to guide future research in nephrology and addiction. Substance-induced kidney injury presents a heterogeneous clinical problem due to the variety of mechanisms and presentations associated with the use of cannabis, cocaine, amphetamine-like stimulants, heroin, synthetic cannabinoids, and synthetic cathinones. This scoping review, conducted between 2015 and 2026 using a PCC approach and JBI guidelines, aimed to map the evidence on mechanisms of kidney damage, clinical manifestations, biomarkers, and renal phenotypes linked to these substances. Primary studies of any design were included, as well as narrative and systematic reviews, in Spanish or English, provided the full text could be assessed. Studies published before 2015, studies without separable data by substance, reports without empirical support, and animal studies without human correlates were excluded. The conceptual scope encompassed acute kidney injury, chronic kidney disease, glomerulopathies, interstitial nephritis, thrombotic microangiopathy, proteinuria, hematuria, cylindruria, and biomarkers such as NGAL and KIM-1. The review also organizes the main pathophysiological mechanisms described in the literature, including inflammation and immunity, intraglomerular hemodynamic alterations, tubular toxicity, crystal nephropathy, rhabdomyolysis, and thrombotic microangiopathy. Overall, the document aims to provide a useful synthesis for defining patterns of kidney damage caused by psychoactive substances and to guide future research in nephrology and addiction