FEATURED NEW INVESTIGATOR Illicit drug use, hypertension, and chronic kidney disease in the US adult population SANJEEV K. AKKINA, ANA C. RICARDO, AMISHI PATEL, ARJUN DAS, LYDIA A. BAZZANO, CAROLYN BRECKLIN, MICHAEL J. FISCHER, and JAMES P. LASH CHICAGO, ILL; TOLEDO, OHIO; AND NEW ORLEANS, LA Illicit drug use has been associated with chronic kidney disease (CKD) in select popu- lations, but it is unknown whether the same association exists in the general population. By using data from the National Health and Nutrition Examination Survey 2005–2008, we conducted a cross-sectional analysis of 5861 adults who were questioned about illicit drug use, including cocaine, methamphetamines, and heroin, during their lifetime. The primary outcome was CKD as defined by an estimated glomerular filtration rate #60 mL/min/1.73 m 2 using the Chronic Kidney Disease Epidemiology Collaboration equa- tion or by microalbuminuria. We also examined the association between illicit drug use and blood pressure (BP) $120/80, $130/85, and $140/90 mm Hg. Logistic regression was used to examine the association between illicit drug use and CKD and BP. Mean estimated glomerular filtration rate was similar between illicit drug users and nonusers (100.7 vs 101.4 mL/min/1.73 m 2 , P 5 0.4), as was albuminuria (5.7 vs 6.0 mg/g creatinine, P 5 0.5). Accordingly, illicit drug use was not significantly associated with CKD in logistic regression models (odds ratio [OR], 0.98; confidence interval [CI], 0.75–1.27) after ad- justing for other important factors. However, illicit drug users had higher systolic (120 vs 118 mm Hg, P 5 0.04) and diastolic BP (73 vs 71 mm Hg, P 5 0.0003) compared with nonusers. Cocaine use was independently associated with BP $130/85 mm Hg (OR, 1.24; CI, 1.00–1.54), especially when used more during a lifetime (6–49 times; OR, 1.42; CI, 1.06–1.91). In a representative sample of the US population, illicit drug use was not associated with CKD, but cocaine users were more likely to have elevated BP. (Translational Research 2012;160:391–398) Abbreviations: BMI ¼ body mass index; CI ¼ confidence interval; CKD ¼ chronic kidney disease; eGFR ¼ estimated glomerular filtration rate; ESKD ¼ end-stage kidney disease; MEC ¼ Mobile Ex- amination Center; NHANES ¼ National Health and Nutrition Examination Survey; OR ¼ odds ratio Sanjeev K. Akkina, MD, is an Assistant Professor of Medicine in the Section of Nephrology at the University of Illinois at Chicago. His article is based on a presentation given at the Combined Annual Meeting of the Central Society for Clinical Research and Midwestern Section American Federation for Medical Research held in Chicago, Ill, April 2011. From the Medicine/Nephrology, University of Illinois at Chicago, Chicago, Ill; Southwest Nephrology Associates, Chicago, Ill; Nephrology Consultants – Northwest Ohio, Toledo, Ohio; Tulane University School of Public Health and Tropical Medicine, New Orleans, La; Nephrology, Stroger Hospital of Cook County, Chicago, Ill; Center for Management of Complex Chronic Care, Jesse Brown VA Medical Center, Chicago, Ill. Sanjeev K. Akkina was supported by a research grant from the Na- tional Institute of Diabetes and Digestive and Kidney Diseases, Award Number K23DK084121. Michael J. Fischer was supported by a Vet- erans Affairs Health Services Research and Development Service Ca- reer Development Award. Ana C. Ricardo was supported by the University of Illinois at Chicago Center for Clinical and Translational Science, Award Number UL1RR029879 from the National Center for Research Resources. None of the authors have a conflict of interest. Submitted for publication October 12, 2011; revision submitted May 24, 2012; accepted for publication May 25, 2012. Reprint requests: Sanjeev K. Akkina, MD, Section of Nephrology (M/ C 793), University of Illinois at Chicago, 820 South Wood Street, Chicago, IL 60612-7315; e-mail: sakkina@uic.edu. 1931-5244/$ - see front matter Ó 2012 Mosby, Inc. All rights reserved. http://dx.doi.org/10.1016/j.trsl.2012.05.008 391