Ketamine-induced uropathy (KIU) is a serious consequence of chronic ketamine abuse, presenting with complex renal and urinary symptoms. This study describes a 34-year-old female with a history of chronic ketamine abuse, resulting in stage 3 chronic kidney disease (CKD) and severe urological complications. Despite discontinuing ketamine use five years ago, she remains dependent on ureteral stents due to recurrent hydronephrosis and ureteral obstruction. The patient began using ketamine at the age of 25 years, consuming approximately 5 g daily for two years. By the age of 27 years, she developed dysuria, flank pain, and burning micturition and was later diagnosed with ketamine-associated cystitis and renal failure secondary to hydronephrosis. Initially, bilateral ureteral stents were placed to manage her condition, but she continued to experience worsening symptoms. Although studies suggest that early cessation of ketamine can resolve ulcerative cystitis and ureteral obstruction, this was not observed in our patient. This case highlights the importance of high suspicion for ketamine abuse in young patients presenting with ureteral complications such as hydronephrosis and cystitis-like symptoms. It highlights the need for early detection, ongoing follow-up, and a comprehensive approach involving pharmacological and surgical interventions. Effective management also requires counseling on ketamine discontinuation to prevent further and permanent damage to the urinary system.
Keywords: bilateral hydronephrosis; burning micturition; ckd (chronic kidney disease); dysuria; flank pain; hydroureteronephrosis; ketamine-associated cystitis; ketamine-induced uropathy; renal failure; ureteral stent.
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