Oral Antibiotics Raise Kidney Stone Risk

Oral antibiotic exposure is associated with an increased risk of nephrolithiasis, especially with recent exposure and among young children, according to new findings.

Researchers arrived at this conclusion following a study of 25,981 patients with nephrolithiasis, along with 259,797 matched controls. Patient data from 1994 to 2015 were obtained from electronic health records in the United Kingdom.

Specifically, the association between 12 classes of oral antibiotics and nephrolithiasis was assessed.

The rate of health care encounters, comorbidities, urinary tract infections, and use of thiazide and loop diuretics, proton-pump inhibitors, and statins were taken into account in conditional logistic regression models.

Results of the study revealed that exposure to antibiotic classes including sulfas (adjusted odds ratio [aOR] 2.33), cephalosporins (aOR 1.88), fluoroquinolones (aOR 1.67), nitrofurantoin/methenamine (aOR 1.70), and broad-spectrum penicillins (aOR 1.27) within 3 to 12 months before the index date was associated with nephrolithiasis.

Findings from exploratory analyses indicated that these associations were greatest for exposure at younger ages and within 3 to 6 months before the index date.

The researchers noted that all classes of antibiotics but broad-spectrum penicillins remained statistically significant 3 to 5 years from exposure.

“Oral antibiotics associated with increased odds of nephrolithiasis, with the greatest odds for recent exposure and exposure at younger age,” the researchers concluded. “These results have implications for disease pathogenesis and the rising incidence of nephrolithiasis, particularly among children.”

—Christina Vogt

Reference:

Tasian GE, Jemielita T, Goldfarb DS, et al. Oral antibiotic exposure and kidney stone disease [Published online May 10, 2018]. J Am Soc Nephrol. doi:10.1681/ASN.2017111213