Antibiotic Use Increases Risk for Kidney Stones Later

Long-term use of antibiotics during young and middle adulthood is associated with an increased risk for kidney stones later in life in women, according to a recent study.

Findings were presented at the American Society of Nephrology’s Kidney Week 2017, which is taking place from October 31 to November 5, 2017, in New Orleans, Louisiana.
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Previous evidence has indicated that intestinal microbiota may contribute to the formation of kidney stones. Since antibiotics are known to alter the gut microbiome, they may raise the risk for kidney stones.

For their study, the researchers evaluated women who had been enrolled in the Nurses’ Health Study I (NHS I; n = 67,051) and II (NHS II; n = 74,467), and examined the independent associations of antibiotic use at age 20 to 39 years and at age 40 to 59 years with the risk of subsequently developing a symptomatic kidney stone.

At least 95% of self-reported incident kidney stones were confirmed via medical record review of a subset of cases. The researchers noted that at least 77% of stones were primarily calcium oxalate. Dietary intake was updated every 4 years with validated food frequency questionnaires. Results were adjusted for age, body mass index, thiazide use, and more via Cox proportional hazards regression.

A total of 1318 incident kidney stones had been recorded over a combined 14 years of follow-up. Results indicated that women who had used antibiotics for at least 2 months between age 20 and 39 years had a multivariable relative risk (MVRR) for kidney stones of 1.41 in NHS I and 1.28 in NHS II, compared with those who had not used antibiotics. Furthermore, women who had used antibiotics for at least 2 months between age 40 and 59 years had MVRR of 1.62 in NHS I and 1.35 in NHS II.

The researchers noted that the results were similar upon the exclusion of women with self-reported urinary tract infections prior to the symptomatic kidney stone event. Additionally, they did not observe any statistically significant interaction between dietary oxalate, antibiotic use, and the risk for kidney stone.

“Long-term antibiotic use in early and middle adulthood may be independently associated with a higher risk of kidney stones later in life,” the researchers concluded.

—Christina Vogt

Reference:

Taylor EN, Curhan GC, Ferraro PM. Antibiotic use and risk of incident kidney stones. Paper presented at: American Society of Nephrology Kidney Week 2017; October 31-November 5, 2017; New Orleans, LA. https://www.asn-online.org/education/kidneyweek/2017/program-abstract.aspx?controlId=2776567.