RENAL CELL CYTOTOXICITY AND ACUTE KIDNEY INJURY: A CLINICAL-BIOLOGICAL EVALUATION OF MARAS POWDER (SMOKELESS TOBACCO) INDUCED NEPHROTOXICITY IN THE EMERGENCY SETTING

ABSTRACT A male patient who presented to the Emergency Department of Karaman Training and Research Hospital exhibited significantly impaired renal function following the use of Maras Powder (a form of smokeless tobacco). This clinical observation is consistent with literature reports indicating that Maras Powder is a highly cytotoxic substance, a finding confirmed by in vitro toxicity studies conducted specifically on renal cell lines. The global use of this product is rapidly expanding, driven by its low cost, easy accessibility, and ability to be consumed without smoke, resulting in its use by younger demographics, including those at the middle school level. Maras Powder poses a serious threat to public health, leading users to seek clinical care for a wide variety of serious conditions, such as oral and dental health problems, peripheral circulatory disorders, cardiovascular issues, withdrawal syndrome, esophageal diseases, pregnancy complications, erectile dysfunction, cognitive decline, and hepatic and renal function impairment. This case underscores the escalating public health risk associated with Maras Powder consumption. Keywords: Renal function, Maras powder, smokeless tobacco, emergency department, toxicity