<prompt> Most common kidney disease associated with chronic heroin use is?IgA nephropathyFocal segmental GNLipod nephrosisMesangioproliferative GN  <response>: Ans. is b i.e., Focal segmental GN Renal disease in cocaine and heroin users is associated with the nephrotic syndrome, acute glomerulonephritis, amyloidosis, interstitial nephritis, and rhabdomyolysis. The predominant renal lesion in black heroin users is focal segmental glomerulosclerosis and in white heroin users is membranoproliferative glomerulonephritis. The pathophysiologic basis of cocaine-related renal injury involves renal hemodynamic changes, glomerular matrix synthesis and degradation, and oxidative stress and induction of renal atherogenesis. CKD in drug abusers is more common with concomitant chronic HIV, hepatitis B virus HBV, and HCV infections. 