In-Depth ReviewsThe Agony of Ecstasy MDMA (3,4-Methylenedioxymethamphetamine) and the KidneyCampbell, Garland A.; Rosner, Mitchell H. Author Information Division of Nephrology, University of Virginia Health System, Department of Medicine, Charlottesville, Virginia Correspondence: Dr. Mitchell H. Rosner, Division of Nephrology, University of Virginia Health System, Department of Medicine, Charlottesville, VA 22908. Phone: 434-924-2187; Fax: 434-924-5848; E-mail: [email protected] Clinical Journal of the American Society of Nephrology 3(6):p 1852-1860, November 2008. | DOI: 10.2215/CJN.02080508 Buy Metrics Abstract Ecstasy (MDMA, 3,4-methylenedioxymethamphetamine) is commonly used by college-aged individuals. Ecstasy leads to feelings of euphoria, emotional empathy, and increased energy. These effects come at a significant risk for complications. Ecstasy has been associated with acute kidney injury that is most commonly secondary to nontraumatic rhabdomyolysis but also has been reported in the setting of drug-induced liver failure and drug-induced vasculitis. More common, ecstasy has led to serious hyponatremia and hyponatremia-associated deaths. Hyponatremia in these cases is due to a “perfect storm” of ecstasy-induced effects on water balance. Ecstasy leads to secretion of arginine vasopressin as well as polydipsia as a result of its effects on the serotonergic nervous pathways. Compounding these effects are the ready availability of fluids and the recommendation to drink copiously at rave parties where ecstasy is used. The effects of ecstasy on the kidney as well as therapeutic measures for the treatment of ecstasy-induced hyponatremia are presented. Copyright © 2008 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.