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Abstract: TH-PO402

Antibiotic Use and Kidney Stone Disease in Patients With Autosomal Dominant Polycystic Kidney Disease

Session Information

Category: Genetic Diseases of the Kidneys

  • 1101 Genetic Diseases of the Kidneys: Cystic

Authors

  • Gitomer, Berenice Y., University of Colorado, Denver, Colorado, United States
  • You, Zhiying, University of Colorado, Denver, Colorado, United States
  • Brosnahan, Godela M., University of Colorado, Denver, Colorado, United States
  • Wang, Wei, University of Colorado, Denver, Colorado, United States
  • Hopp, Katharina, University of Colorado, Denver, Colorado, United States
  • Nowak, Kristen L., University of Colorado, Denver, Colorado, United States
  • Jovanovich, Anna, University of Colorado, Denver, Colorado, United States
  • Chapman, Arlene B., University of Chicago Pritzker School of Medicine, Chicago, Illinois, United States
  • Perrone, Ronald D., Tufts Medical Center, Boston, Massachusetts, United States
  • Torres, Vicente E., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Yu, Alan S.L., The University of Kansas Medical Center, Kansas City, Kansas, United States
  • Chonchol, Michel, University of Colorado, Denver, Colorado, United States
Background

Kidney stone disease (KSD) occurs in ~ 20% of patients with autosomal dominant polycystic kidney disease (ADPKD) and is associated with overall disease morbidity, including risk for faster kidney disease progression. Recent evidence suggests that changes in the normal gut microbiome linked with antibiotic use play a causal role in kidney stone disease in the non-ADPKD population. However, antibiotic exposure as a novel risk factor for kidney stone formation has not been explored in ADPKD patients, who are frequently treated with antibiotics for urinary tract and cyst infections.

Methods

We analyzed use of the following oral antibiotic classes: cephalosporin, fluoroquinolone, nitrofurantoin/methenamine, sulfa, and broad-spectrum penicillin in the HALT-PKD patient cohort. Antibiotic use preceding self-reported KSD (prior to the report of a kidney stone) was compared to those with no KSD (NKSD) by chi-square test.

Results

One hundred and forty three patients reported oral antibiotic exposure over the course of the HALT-PKD study. Antibiotic exposure was significantly higher in patients with subsequent KSD compared to those with NKSD (figure 1). Patients with KSD have a significantly faster rate of decline in eGFR compared to patients without a kidney stone, mean slope of annual decline in NKSD compared to KSD -3.64 ± 4.1 vs. -5.2 ± 8.3.

Conclusion

Antibiotic exposure may represent a novel risk factor for kidney stone disease in patients with ADPKD or KSD may lead to antibiotic exposure in this population. Further studies are necessary to address these questions and to better understand the associated mechanisms.

Funding

  • NIDDK Support