Association of Oral Tobacco-Free Nicotine Delivery Product with Acute Renal Tubular Necrosis

Usage of novel non-tobacco oral nicotine delivery products (ONDP) has been increasing among adolescents in the United States. It is presumed that they are less toxic than their tobacco containing counterparts, but that has not been examined in controlled studies. Most of the studies have focused on non-renal manifestations of tobacco consumption via different means. The renal manifestations of non-tobacco ONDPs are not very well known, especially in immunocompromised patients. Here, we describe a 19-year-old adolescent with kidney transplant who sustained acute tubular necrosis leading to advanced chronic disease apparently following the usage of non-tobacco ONDP. Further larger studies are needed to study the renal manifestations of these next generation products to raise awareness among public.