Abstract: SA-OR026

Antibiotic Use and Risk of Incident Kidney Stones

Session Information

Category: Mineral Disease

  • 1204 Mineral Disease: Nephrolithiasis

Authors

  • Taylor, Eric N., Maine Medical Center, Portland, Maine, United States
  • Curhan, Gary C., Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Ferraro, Pietro Manuel, Fondazione Policlinico Universitario A. Gemelli, Rome, ROME, Italy
Background

Intestinal microbiota may play a role in the formation of kidney stones. Antibiotics alter the gut microbiome and therefore represent a potential risk factor for kidney stones.

Methods

We prospectively examined the independent associations between antibiotic use at age 20 to 39 and age 40 to 59 with risk of a subsequent symptomatic, incident kidney stone in the Nurses’ Health Study I (NHS I; N=67,051 women). We also examined antibiotic use at age 20 to 39 and age 40 to 49 in the Nurses’ Health Study II (NHS II; N=74,467 women). Medical record review of a subset of cases confirmed > 95% of self-reported incident kidney stones in each cohort, and the majority of stones (> 77%) were predominantly calcium oxalate. Validated food frequency questionnaires were used to update dietary intakes every four years. Cox proportional hazards regression was used to adjust for age, body mass index, thiazide use, family history of kidney stones, hypertension, diabetes, fluid intake, supplemental calcium, and dietary factors.

Results

We documented 1,318 incident kidney stones over a combined 14 years of follow-up. At baseline, mean age was 68 in NHS I and 50 in NHS II. Compared with non-users, women who used antibiotics for > 2 months between age 20 to 39 had a multivariable relative risk (MVRR) for kidney stones of 1.41 (95% CI 0.95 to 2.09) in NHS I and 1.28 (95% CI 0.87 to 1.89) in NHS II. Compared with non-users, women who used antibiotics for > 2 months between age 40 to 59 in NHS I and between age 40 to 49 in NHS II had MVRRs for kidney stones of 1.62 (95% CI 1.01 to 2.60) and 1.35 (95% CI 1.00 to 1.84), respectively. Excluding women with self-reported urinary tract infections before the symptomatic kidney stone event did not change the results. There was no statistically significant interaction between dietary oxalate, antibiotic use, and kidney stone risk.

Conclusion

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

Funding

  • NIDDK Support