Posters
Academic Level (Author 1)
Medical Student
Discipline/Specialty (Author 1)
Internal Medicine
Academic Level (Author 2)
Faculty
Discipline/Specialty (Author 2)
Internal Medicine
Academic Level (Author 3)
Medical Student
Discipline/Specialty (Author 3)
Psychiatry
Discipline Track
Patient Care
Abstract
Background: Polysubstance abuse and addiction are multifactorial in etiology. It has been reported that there is a higher prevalence amongst low-income areas. Marijuana was used at a higher frequency amongst people with lower educational status and different minority groups. In the Rio Grande Valley, the poverty rates are higher, and high school graduation rates are lower when compared nationally. The following case is an example of how the prevalence of poor social determinants of health can allow for poor health outcomes, in this case, an acute kidney injury.
Case Presentation: A 26-year-old man with no significant medical history arrived at the emergency department complaining of nausea and vomiting for the past four days while doing yard work, accompanied by dizziness and occasional headaches. Associated symptoms included low urine output, no bowel movements, and unable to tolerate solids or liquids. Upon further history, he consistently used cocaine and marijuana and tried the latter to alleviate his symptoms without success.
Upon admission, his vitals were stable, with slight hypotension. His laboratory results showed hyponatremia and hypochloremia. His BUN was 70 mg/dL (8-20 mg/dL), creatinine was 4.08 mg/dL (0.6-1.3 mg/dL), creatine kinase was 993 IU/L (22-334 IU/L), and his GFR was 19.7 mL/min/1.73 m2 (90-120 mL/min/1.73 m2), confirming prerenal kidney injury. Additional tests included urine drug screening that was positive for marijuana and cocaine.
He was admitted to the Telemetry unit due to transient hypotension and acute kidney injury, likely due to cannabis hyperemesis syndrome. He was given a 500 mL lactated ringer solution, which restored his hypovolemic state. Unfortunately, this patient has no insurance, and despite the team's recommendation, he showed no interest in establishing care with a primary care physician. He was discharged the next day after his kidney function was corrected.
Conclusions: This patient's case underscores the urgent need to enhance social determinants of health in low-income areas like the Rio Grande Valley. With better access to healthcare and health information, the patient's outcomes could have been different. Establishing care with a primary care physician could have provided the patient with the necessary education on the signs and symptoms of acute kidney injury, potentially leading to more prompt care-seeking.
Presentation Type
Poster
Recommended Citation
Abrego, Edwardo II; Suarez Parraga, Andres; and Torres, Juan Diego, "The Role of Social Determinants of Health Involving Polysubstance Abuse and Acute Kidney Injury: A Case Report" (2024). Research Colloquium. 18.
https://scholarworks.utrgv.edu/colloquium/2024/posters/18
Included in
The Role of Social Determinants of Health Involving Polysubstance Abuse and Acute Kidney Injury: A Case Report
Background: Polysubstance abuse and addiction are multifactorial in etiology. It has been reported that there is a higher prevalence amongst low-income areas. Marijuana was used at a higher frequency amongst people with lower educational status and different minority groups. In the Rio Grande Valley, the poverty rates are higher, and high school graduation rates are lower when compared nationally. The following case is an example of how the prevalence of poor social determinants of health can allow for poor health outcomes, in this case, an acute kidney injury.
Case Presentation: A 26-year-old man with no significant medical history arrived at the emergency department complaining of nausea and vomiting for the past four days while doing yard work, accompanied by dizziness and occasional headaches. Associated symptoms included low urine output, no bowel movements, and unable to tolerate solids or liquids. Upon further history, he consistently used cocaine and marijuana and tried the latter to alleviate his symptoms without success.
Upon admission, his vitals were stable, with slight hypotension. His laboratory results showed hyponatremia and hypochloremia. His BUN was 70 mg/dL (8-20 mg/dL), creatinine was 4.08 mg/dL (0.6-1.3 mg/dL), creatine kinase was 993 IU/L (22-334 IU/L), and his GFR was 19.7 mL/min/1.73 m2 (90-120 mL/min/1.73 m2), confirming prerenal kidney injury. Additional tests included urine drug screening that was positive for marijuana and cocaine.
He was admitted to the Telemetry unit due to transient hypotension and acute kidney injury, likely due to cannabis hyperemesis syndrome. He was given a 500 mL lactated ringer solution, which restored his hypovolemic state. Unfortunately, this patient has no insurance, and despite the team's recommendation, he showed no interest in establishing care with a primary care physician. He was discharged the next day after his kidney function was corrected.
Conclusions: This patient's case underscores the urgent need to enhance social determinants of health in low-income areas like the Rio Grande Valley. With better access to healthcare and health information, the patient's outcomes could have been different. Establishing care with a primary care physician could have provided the patient with the necessary education on the signs and symptoms of acute kidney injury, potentially leading to more prompt care-seeking.