- Cumulative use of antibiotics for ≥2 months in early adulthood and middle age is tied to an increased risk for kidney stones in later life.
Why this matters
- Antibiotics alter the intestinal microbiome, potentially affecting kidney stone development by modulating oxalate absorption and excretion.
- Data for 5010 women in the prospective Nurses’ Health Studies (NHS) I and II with available 24-hour urine samples.
- Analysis adjusted for age, BMI, comorbidities, thiazide use, and dietary factors.
- Funding: NIH.
- Indications most commonly included respiratory infection (52%-53%), UTIs (11%-15%), and dental infections (7%-10%).
- Aged 40-49/59 years: 1059 subsequent kidney stone incidents over 694,194 person-years.
- Risk was 48% higher with cumulative antibiotic use ≥2 months vs no use (pooled HR, 1.48; 95% CI: 1.12-1.96).
- Aged 20-39 years: 1059 subsequent kidney stone incidents over 694,193 person-years.
- Risk was 36% higher with cumulative antibiotic use ≥2 months vs no use (pooled HR, 1.36; 95% CI: 1.00-1.84).
- Findings were consistent after excluding patients reporting UTIs as the most common indication, or UTIs with kidney stones.
- Urine pH and citrate levels were marginally lower with ≥2 months of antibiotic use.
- Observational design.
- May not extrapolate to men.
- Antibiotic type was not captured.
- Interval between antibiotic use, urine collection.