Complete recovery of thrombotic microangiopathy with severe acute kidney injury due to intravenous use of modified release oxycodone

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ID: 327888
2026
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Abstract
Abstract Since the introduction of the tamper-resistant oral formulation of modified-release oxycodone (OxyContin®), cases of thrombotic microangiopathy (TMA) have been reported following intravenous injection of the drug. Previous reports have suggested that withdrawal of the offending agent alone may be sufficient to reverse the condition; however, the associated acute kidney injury (AKI) in these cases was only mild to moderate in severity. We report the first case of OxyContin®-associated TMA presenting with anuric AKI requiring dialysis, followed by complete renal recovery after cessation of intravenous OxyContin® use. This case demonstrates that withdrawal of the causative agent may be sufficient to achieve resolution of TMA even in severe presentations. Accordingly, supportive management without the need for invasive and costly interventions may be appropriate in selected cases. Awareness of the association between intravenous OxyContin® use and TMA is essential for timely diagnosis, as identification often depends on direct inquiry regarding drug exposure.
Reference Key
openalex_W7211900236 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Moses Ezeakile, Tasnim Zirapury
Journal clinical kidney journal
Year 2026
DOI
10.1093/ckj/sfag292
URL
https://doi.org/10.1093/ckj/sfag292
Keywords Keywords not found

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