COMMENTARY

Rising Kidney Stone Incidence: Is This Novel Risk Factor the Reason?

Arefa Cassoobhoy, MD, MPH

Disclosures

May 30, 2018

Hello. I'm Dr Arefa Cassoobhoy, a practicing internist, Medscape advisor, and senior medical director for WebMD. Welcome to Morning Report, our 1-minute news story for primary care.

The prevalence of kidney stones in the general population has risen by 70% over the past 30 years. In a recent UK study involving about 26,000 patients with kidney stones, investigators found a link between nephrolithiasis risk and five common types of antibiotics. Most kidney stones developed within a year after the antibiotics were taken, but the risk remained elevated for several years.

The antibiotics of concern were sulfas, cephalosporins, fluoroquinolones, nitrofurantoin, and broad-spectrum penicillins. The added risk was highest for the sulfa drugs. And although all ages were affected, the danger was highest among adolescents and children.

The reasons why oral antibiotics promote the development of kidney stones aren't clear. It might be that antibiotics induce changes to the microbiome or to macronutrient metabolism.

But it's another reminder that antibiotics aren't risk-free. And for patients already at risk for nephrolithiasis, it would be prudent to avoid these antibiotics when possible.

Follow Dr Cassoobhoy on Twitter at @ArefaMD

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