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Marijuana and Cannabinoids in ESRD and Earlier Stages of CKD.

Authors
  • Rein, Joshua L1
  • Wyatt, Christina M2
  • 1 Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: [email protected]
  • 2 Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Type
Published Article
Journal
American Journal of Kidney Diseases
Publisher
Elsevier
Publication Date
Aug 12, 2017
Identifiers
DOI: 10.1053/j.ajkd.2017.06.020
PMID: 28811049
Source
Medline
Keywords
License
Unknown

Abstract

Marijuana is the most commonly used recreational drug in the United States, and legal recreational and medicinal use has gained public acceptance during the last decade. Twenty-nine US states have established medical marijuana programs, 8 of which have also legalized recreational marijuana, and Canada is expected to legalize recreational marijuana in 2018. Advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) are chronic conditions with significant associated morbidity and mortality. Patients experience substantial symptom burden that is frequently undertreated due to adverse medication side effects. This article reviews the available evidence for the use of medical marijuana to manage chronic pain, nausea/vomiting, anorexia/cachexia, and pruritus, all of which are frequently reported by patients with advanced CKD or ESRD. Potential adverse health effects of medical and recreational marijuana use are also discussed. Regardless of personal, social, and political beliefs, marijuana use is becoming mainstream, and nephrologists should be aware of the potential impact on our patient population. Further research is warranted to investigate the renal endocannabinoid system, the impact of marijuana use on kidney disease outcomes, and the risks and benefits of medical marijuana use on symptoms of advanced CKD and ESRD.

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