Ketamine-Induced Uropathy: The Detrimental Effects of Chronic Ketamine Abuse Beyond the Bladder-A Case Report with a Brief Literature Review

Bladder toxicity associated with high-dose recreational ketamine use, is well-documented. However, the upper tract merits more attention because hydronephrosis may not solely stem from impaired bladder compliance and vesicoureteral reflux. We report an autopsy case of a 28-year-old man with extensive upper tract pathology, indicating that the direct effects of ketamine and its metabolites extend beyond the bladder. Urothelial denudation, chronic transmural inflammation, ureteric fibrosis, interstitial nephritis, and papillary necrosis in the kidney were observed. Our findings underscore the importance of assessing ureteral integrity before bladder surgery given that unrecognized strictures may complicate reconstructive procedures and lead to kidney failure.