Tramadol-Induced Liver and Kidney Toxicity among Abusers in Gaza Strip, Palestine

Tramadol, a centrally acting analgesic opioid, is considered to have a low abuse potential and is devoid of side effects like drug dependence, liver and kidney toxicity.. The present study was conducted to assess the tramadol addiction effects on both liver and kidney functions among tramadol abusers. A total of 50 male individuals with a tramadol abuse problem were referred to psychiatric clinics in Gaza Strip, along with an age matched normal control. An informed consent was obtained, a questionnaire was filled, blood samples were collected, serum was separated, and tested serologically to detect antibodies to hepatitis A virus, the presence of hepatitis B surface antigen, and IgM antibodies to hepatitis A virus. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) activities, bilirubin, creatinine, uric acid and blood urea nitrogen (BUN) levels were measured in the serum. Serum ALT, AST and LDH levels were significantly higher in abuser group compared to the control group. Serum ALP, direct bilirubin, total bilirubin, BUN, uric acid and creatinine levels significantly increased in the abusers that were addicted to tramadol for more than 5 years. Our results point out the risk of increased hepatic and renal damage due to a long-term use of tramadol. Although opioids are reported to be effective in pain management, their toxic effects should be kept in mind during the chronic usage. In addition, measures to control the spread of tramadol abuse should be implemented.