Erman ÖZDEMİR, Erdoğan ÖZDEMİR, Pınar ÖZDEMİR
Kocaeli Üniversitesi Sağlık Bilimleri Dergisi - 2026;12(3):305-310
Objective: Synthetic cannabinoid -associated acute kidney injury (SC -AKI) is difficult to recognize because routine toxicology may not detect emerging compounds and exposure may initially be undisclosed. We evaluated whether metabolic alkalosis and microscopic hematuria identify a distinct clinical pattern among young adults with severe AKI. Methods: This single -center retrospective frequency -matched study included patients aged 18 -45 years with KDIGO stage 3 AKI evaluated between January 2016 and December 2023. Eleven patients with probable SC -AKI were compared with 44 non -SC AKI controls matched by sex, age distribution, admission creatinine, and peak creatinine. Fisher exact and Mann -Whitney U tests were used. Results: Median age was 34 versus 35 years and admission creatinine was 5.9 versus 6.25 mg/dL. Metabolic alkalosis occurred in 7/11 SC -AKI patients and 5/44 controls (p<0.001), whereas metabolic acidosis occurred in 0/11 and 26/44, respectively (p<0.001). Microscopic hematuria was present in 11/11 versus 13/44 (p<0.001). The combined alkalosis -hematuria -symptom phenotype occurred in 7/11 versus 3/44 patients (p<0.001; specificity 93.2%). Dialysis dependence at last follow -up occurred in 7/11 versus 4/44 patients (p <0.001). Conclusion: In this selected cohort, metabolic alkalosis with microscopic hematuria was strongly associated with probable SC -AKI. The finding may support targeted exposure reassessment in young adults with otherwise unexplained severe AKI but requires prospective validation.
