METABOLIC ALKALOSIS AND MICROSCOPIC HEMATURIA IN SYNTHETIC CANNABINOID-ASSOCIATED ACUTE KIDNEY INJURY: A FREQUENCY-MATCHED COMPARATIVE STUDY

Objective: Synthetic cannabinoid-associated acute kidney injury (SC-AKI) is difficult to recognize because routine toxicology may not detect emerging compounds and exposure may initially be undisclosed. We evaluated whether metabolic alkalosis and microscopic hematuria identify a distinct clinical pattern among young adults with severe AKI.Methods: This single-center retrospective frequency-matched study included patients aged 18-45 years with KDIGO stage 3 AKI evaluated between January 2016 and December 2023. Eleven patients with probable SC-AKI were compared with 44 non-SC AKI controls matched by sex, age distribution, admission creatinine, and peak creatinine. Fisher exact and Mann-Whitney U tests were used.Results: Median age was 34 versus 35 years and admission creatinine was 5.9 versus 6.25 mg/dL. Metabolic alkalosis occurred in 7/11 SC-AKI patients and 5/44 controls (p