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Table 1 Case reports about methadone induced rhabdomyolysis and AKI

From: Nephrotoxicity of methadone: a systematic review

Author Age/gender Methadone dose Primary signs and symptoms Lab parameters Outcome
Hojs and Sinkovic (1992) 28/Male 30 mg IV Comatose, cyanotic congenital heart disease, and shallow breathing, anuria Urea: 124 mg/dl Creatinine: 2.18 mg/dl Myoglobin-positive urine. CK: 12,000 U/L Discharged in good condition
Chakera (2008) 30/Male 120 mg Unconsciousness CK: “increased” Metabolic acidosis, anuria. After 7 sessions of dialysis, renal function started to recover.
Hsu et al. (2009) 33/Male 150 mg/day (heroin user) Unconsciousness CK: 17,680 U/L, Cr: 2.9 mg/dl myoglobin: >4000 Cerebral ischemic infarction
Nanji and Douglas Filipenko (1983) 31/Male “Large amount” of methadone Respiratory distress, but awake BUN: 24 mg/dl, Creatinine: 2.2 mg/dl CK: 7500 U/L. Recovered
Gramenz et al. (2010) Not mentioned 10-mg methadone tablets dissolved in water and injected into femoral artery Severe pain and leg cyanosis. No unconsciousness CK: 4208 U/L. Responded to medical therapy
Valga-Amado et al. 2012 41/Male   Muscle weakness and widespread myalgia, Reduced consciousness Creatinine: 2.88 mg/dl; CK: 86,000  IU/l. Recovered
Mittal et al. 38/Male Methadone and diazepam ingestion Unconsciousness methadone-induced delayed posthypoxic encephalopathy CK: 3339 IU/l BUN: 13 mg/dl Creatinine: 3.2 mg/dl (diagnosis of AKI was made). Treated successfully with combination of steroids and antioxidants
Weston et al. 27/Male Not mentioned Unconsciousness CK: 31,500 u/l Urine osmolality: 292 mosmol/l (diagnosis of AKI was made) Full recovery
David et al. 1 24/Male 40 mg IV Comatose, Shallow breathing, pulmonary edema BUN: 62 mg/dl Creatinine: 3.9 mg/dl. CK: 6750 IU/l Discharged in good condition
David et al. 2 25/Male 50 mg /IV Apneic, comatose, pulmonary edema BUN: 132 mg/dl Creatinine: 5.2 mg/dl CK: 190 IU /L Died