Case report: severe muscle breakdown and kidney injury after ayahuasca use

The question

Can drinking ayahuasca be linked to rhabdomyolysis, a severe breakdown of muscle tissue that can damage the kidneys?

What they did

Doctors describe one previously healthy man who drank ayahuasca, a plant brew containing DMT plus compounds that block an enzyme breaking down brain chemicals. He then travelled for a prolonged period and arrived at hospital with widespread muscle pain and dark urine. He was admitted to intensive care and treated with large volumes of intravenous fluids, close monitoring and correction of blood salts, and avoidance of drugs that can harm the kidneys.

What they found

On arrival his creatine kinase, a blood marker of muscle damage, was 110,659 IU/L, with creatinine at 6.8 mg/dL and blood urea nitrogen around 95 mg/dL, indicating severe acute kidney injury. Hospital toxicology screens were negative for non-prescribed substances. Despite early treatment, creatinine rose to 13.6 mg/dL by hospital day 7 and blood urea nitrogen peaked around 130 mg/dL. The muscle marker fell quickly, below 1,500 IU/L by day 9 and to 730 IU/L by day 11; kidney function started to improve after its peak but was still impaired at discharge, and he was referred to a kidney specialist. He was managed without dialysis and showed no sign of compartment syndrome.

The fine print

This is one patient, so it cannot establish cause or say how common this outcome is. The authors note other contributing factors, including dehydration and prolonged travel, and describe the circumstances of the exposure as uncertain. There is no long-term follow-up on whether kidney function fully recovered, and this summary is based only on the published abstract.

What it means

A single detailed case suggests that severe muscle breakdown and kidney injury can follow ayahuasca use, particularly alongside dehydration and exertion, and that clinicians should keep plant-based hallucinogens in mind when muscle damage markers are very high.

Evidence grade: Very low. This is a single patient case report, which cannot show how often such harm occurs or prove ayahuasca was the cause.

This summary is based on the study’s published abstract.