Melanotan II: a possible cause of renal infarction: review of the literature and case report.

This paper presents a case report combined with a literature review examining a possible association between Melanotan II (MTII) — a non-selective melanocortin-receptor agonist commonly used illicitly for skin tanning, penile erection, and sexual stimulation — and renal infarction. The authors describe a patient who experienced renal infarction most likely attributed to MTII use. Renal infarction, an uncommon and potentially life-threatening condition caused by acute disruption of renal blood flow, is noted to be frequently misdiagnosed or diagnosed late. The paper reviews prior literature documenting MTII-associated rhabdomyolysis and renal failure, and proposes two potential mechanisms of renal injury: a thrombotic pharmacological effect and possible direct toxic effects on renal parenchyma. Limitations are significant: evidence rests on a single case and a narrative review of prior case-level reports, meaning causality cannot be formally established. No controlled data are available, and the condition's rarity makes systematic study difficult. The authors conclude that MTII's thrombotic and potentially nephrotoxic properties warrant clinical awareness, particularly given the compound's widespread unregulated use.

Why this grade: Evidence is limited to a single case report supplemented by a narrative literature review, with no control group or systematic methodology, preventing causal conclusions.