Can We Better Understand, Diagnose, and Treat Ketamine-Induced Uropathy, and Can It Be Reversed? ICI-RS 2024.
Neurourology and urodynamics March 1, 2025 François Hervé, Patrik Aronsson, D Carolina Ochoa et al. 1 citation
Ketamine-induced uropathy (KIU) causes lower urinary tract symptoms and can affect the upper urinary tract. Bladder fibrosis driven by transforming growth factor-β1, elevated purinergic responses with upregulated P2X1 purinoceptor expression, decreased barrier function from increased antiproliferative factor, and functional bladder loss through Cav1.2 channel blockade are key mechanisms. Fibrosis, typically considered irreversible, may be mitigated, but the timing and extent of its initiation require further research. Symptoms usually improve after ketamine cessation but relapse upon resumption, suggesting a hypersensitivity mechanism involving elevated serum IgE. Advanced KIU does not always correlate with symptom severity, indicating potential systemic effects. Psychological dependency complicates cessation, and long-term management requires a holistic approach addressing both urological and psychological aspects.