Paediatric Ketamine Bladder Case Report: A Burgeoning Problem in the Paediatric Population.
Shreya Kulkarni, Arjun Visa, Marita Isaac, Joanne Parr, E Charlotte Dunford, Ravindar Anbarasan, Azad Mathur, Milind Kulkarni
Case reports in pediatrics 2026 DOI: 10.1155/crpe/2254453 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A 15-year-old boy with a history of heavy recreational ketamine use |
| Intervention | community drug and alcohol support services |
| Dose | up to 2 g/day |
| Measures | albumin-creatinine ratio |
| Topics | Esketamine Ketamine |
| Keywords | Case report Ketamine abuse Ketamine-induced uropathy Paediatrics |
| Key findings | The authors describe a 15-year-old boy with ketamine-induced uropathy whose bladder imaging abnormalities and raised albumin-creatinine ratio improved after he significantly reduced his ketamine use with support from community drug and alcohol services. They argue this highlights the potential reversibility of the disease with early intervention and abstinence, and propose a tailored paediatric management framework drawing on adult consensus guidance. |
Abstract
Ketamine misuse is an increasing public health concern among adolescents in the United Kingdom, with initiation reported as early as 14 years of age and a rapidly rising demand for drug and alcohol support services. Chronic ketamine misuse is associated with significant urological sequelae, including ketamine-induced uropathy, a condition increasingly encountered within paediatric and adolescent populations. Despite this trend, there remains a lack of unified paediatric-specific management guidelines. We present the case of a 15-year-old boy who was referred urgently with abdominal pain and haematuria. Imaging revealed a thick-walled, irregular bladder with vascular soft tissue plaques, alongside a significantly raised albumin-creatinine ratio. Further assessment identified a history of heavy recreational ketamine use (up to 2 g/day) commencing at age 14. Following engagement with community drug and alcohol support services, the patient significantly reduced ketamine use, with subsequent improvement in symptoms, highlighting the potential reversibility of disease with early intervention and abstinence. This case underscores the emerging burden of ketamine-induced uropathy in paediatric urology and the need for a structured, age-appropriate management approach. Drawing on existing adult consensus guidance, we propose a tailored paediatric framework incorporating early noninvasive investigations, stepwise escalation of treatment, multidisciplinary involvement and close collaboration with youth-focused substance misuse services. Increased reporting and research into paediatric ketamine uropathy are essential to clarify disease trajectory, inform clinical guidelines and support public health strategies aimed at reducing long-term urological morbidity in young people.
Comparable studies
Other case reports and case series on ketamine, most cited first.