Dr. Cao Vinh Duy, a urologist at the Center for Urology - Nephrology - Andrology, Tam Anh General Hospital TP HCM, stated that drugs can damage the urinary system through various mechanisms. Long-term ketamine (a synthetic drug) users risk developing ketamine-induced cystitis, characterized by urgent urination, frequent urination, painful urination, bladder pain, and reduced bladder capacity. Severe cases can lead to ureteral reflux, hydroureteronephrosis, and impaired kidney function.

Some drugs can directly poison the kidneys, disrupt bladder and urinary tract function, impair the body's excretory function, and affect the patient's reproductive health. Additionally, many drugs are mixed with impurities or toxic chemicals, which can cause acute kidney injury, interstitial nephritis, or other systemic complications, worsening kidney damage.

Dr. Duy examines and advises a patient. *Photo: Tam Anh General Hospital*

Dr. Duy highlighted five common effects of drugs on the urinary system:

Acute kidney injury

The kidneys are among the organs directly affected by addictive substances. Some drugs, such as heroin, cocaine, or methamphetamine (crystal meth), can cause severe constriction of the blood vessels supplying the kidneys, reducing blood flow to the organ.

Drug users often experience dehydration, hyperthermia, or rhabdomyolysis (widespread destruction of muscle cells), leading to obstruction and toxicity in the renal tubules, causing acute kidney failure. Without timely treatment, patients may require emergency dialysis.

Increased risk of chronic kidney failure

Prolonged drug use can damage the glomeruli and renal interstitium. Some damage may be reversible if use is stopped early; however, many cases progress to irreversible chronic damage. Certain substances also increase blood pressure, causing fibrosis of small blood vessels in the kidneys. Over time, nephrons (the functional units of the kidneys) are gradually destroyed, impairing blood filtration and potentially progressing to chronic kidney disease, or even end-stage kidney failure requiring hemodialysis or kidney transplant.

Bladder and urination dysfunction

The central nervous system and autonomic nervous system control bladder and urethral sphincter activity. Depending on the type of addictive substance, users may experience urinary retention, difficulty urinating, or conversely, urgent and frequent urination due to bladder neuroregulation disorders. Prolonged urine retention in the bladder increases the risk of infection and upper urinary tract damage.

Urinary tract infections

Drug users often have poor nutrition, inadequate personal hygiene, are prone to co-occurring infections, and may have weakened immune systems, all increasing the risk of urinary tract infections. Urinary retention or incomplete bladder emptying due to bladder dysfunction creates conditions for bacteria to grow in residual urine. Patients risk developing cystitis, urethritis, or, in more severe cases, pyelonephritis.

Impact on reproductive function

In men, drugs can disrupt the hypothalamic-pituitary-testicular endocrine axis, leading to reduced testosterone production, impaired spermatogenesis, and an increased risk of erectile dysfunction and infertility. Some cases also report testicular atrophy after prolonged use of addictive substances. Additionally, drugs increase oxidative stress in the testes, affecting sperm count, motility, and quality.

In women, addictive substances can disrupt sex hormones, affect ovarian function, causing menstrual irregularities or amenorrhea. Prolonged conditions can reduce fertility, increasing the risk of infertility by affecting ovulation and egg quality. Pregnant women who use drugs also face risks of miscarriage, premature birth, intrauterine growth restriction, and many other severe complications for newborns.

According to Dr. Duy, many drug-induced injuries to the kidneys and urinary tract may not fully recover, especially when detected late. Individuals with a history of addictive substance use should undergo regular check-ups to assess kidney function and detect complications early. If abnormal signs appear, such as painful urination, blood in urine, difficulty urinating, swelling in limbs, lower back pain, or impaired kidney function, patients should seek early medical attention for timely treatment.

Dinh Lam