A Deleterious Combination of Intravenous Drug Usage with HIV and Chronic Hepatitis Infection: How Renal Replacement Therapy Emanated?

Abstract

Christian Castillo-Latorre, Hector R Cintron-Colon, Fermin Lopez-Rivera, Manuel Urbina-Paredes, Alexis Rivera-Gonzalez, Maricarmen Milan-Esteva and Luis Gerena-Montano

Intravenous drug usage of substances like cocaine and heroin; encompasses a spectrum of generalized state of illness. A continuum insult which predispose patients to chronic viral illnesses, bacterial infections and subsequently end organ damage due to multiple factors. The renal structure is one of the target organs involved in this process, by which a majority of them will lately developed end stage renal disease and as a result renal replacement therapy. However, the spectrum of complications of this population is enormous starting with acquire infections like HIV, Hepatitis C, Hepatitis B, severe skin infections, pneumonias, cardiovascular diseases, endovascular complications as the well-known Lemierre’s syndrome, central nervous system infections, systemic complications like renal failure ending up in hemodialysis and most of them with a low expectancy of life. In our population 69 patients were randomly with a mean age of 44 years assign for investigation all of them known to have a poor social support in conjunction with intravenous drug usage of cocaine and heroin. All these patients were study using the electronic medical record system, several conditions were measure like HIV, Hepatitis B, Hepatitis C, Hypertension and Diabetes mellitus. Of the patients been study the admission diagnosis that lead to renal replacement therapy was recorded, and later in the process compared. Our population of 69 patients, 16 of them ended up in hemodialysis 23% (16/69), of this patients that had renal replacement therapy 4 of them had Hepatitis C 25% (4/16), Hepatitis B 19% (3/16), HIV 13% (2/16), Hypertension 6% (1/16) and Diabetes mellitus 6% (1/16) respectively. There were several precise findings that lead to hemodialysis in the population, with the majority been infected ulcers 25% (17/69), pneumonia 20% (14/69), upper gastrointestinal bleeding in 10 %(7/69) and symptomatic anemia 10% (7/69) respectively. All of this patient did not have good social support, none of them knew about the long-term consequences of renal failure and most of them did not had positive approach of stopping intravenous drug usage. As a whole, illicit intravenous drug usage is associated with a broad spectrum of diseases, all of them creating a rapid deleterious clinical picture; mostly debuting to medical assistance with infectious etiologies.

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