Study Finds Link Between Antibiotics And Kidney Stones
The overall prevalence of kidney stones has risen by 70 percent over the past 30 years, with particularly sharp increases among adolescents and young women. Kidney stones were previously rare in children. This increased incidence is a public health concern.
In a study recently published in the Journal of the American Society of Nephrology, CHOP researchers have found that children and adults treated with some oral antibiotics have a significantly higher risk of developing kidney stones. This is the first time that these medicines have been linked to this condition. The strongest risks appeared at younger ages and among patients most recently exposed to antibiotics.
The reasons for the increase are unknown, but study findings suggest that oral antibiotics may play a role, especially given that children are prescribed antibiotics at higher rates than adults, says study senior author Michelle Denburg, MD, MSCE, a pediatric nephrologist at Childrens Hospital of Philadelphia . Denburg partnered with lead author Gregory Tasian, MD, MSc, MSCE, a CHOP pediatric urologist.
The study team drew on electronic health records from the United Kingdom, covering 13 million adults and children seen by general practitioners in The Health Improvement Network between 1994 and 2015. The team analyzed prior antibiotic exposure for nearly 26,000 patients with kidney stones, compared to nearly 260,000 control subjects.
Drink Lots Of Liquid Especially Water
Liquids can help flush bacteria from the urinary system. Water is best. Most healthy people should try to drink six to eight, 8-ounce glasses of liquid each day. If you need to drink less water because of other health conditions, such as bladder control problems, kidney failure or heart disease, ask your health care provider how much liquid is healthy for you.
What Are Kidney Stones
Kidney stones are solid crystals formed from the salts in urine. They are sometimes called renal calculi. Kidney stones can block the flow of urine and cause infection, kidney damage or even kidney failure. They can vary in size and location.
The risk of kidney stones is about one in 10 for men and one in 35 for women. Between four and eight per cent of the Australian population suffer from kidney stones at any time.
After having one kidney stone, the chance of getting a second stone is between five and 10 per cent each year. Thirty to fifty per cent of people with a first kidney stone will get a second stone within five years. After five years, the risk declines. However, some people keep getting stones their whole lives.
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Diagnosis Of Kidney Infection
Imaging tests Imaging Tests of the Urinary Tract There are a variety of tests that can be used in the evaluation of a suspected kidney or urinary tract disorder. X-rays are usually not helpful in evaluating… read more are done in people who have intense back pain typical of renal colic, in those who do not respond to antibiotic treatment within 72 hours, in those whose symptoms return shortly after antibiotic treatment is finished, in those with long-standing or recurring pyelonephritis, in those whose blood test results indicate kidney damage, and in men . Ultrasonography or helical computed tomography studies done in these situations may reveal kidney stones, Stones in the Urinary Tract Stones are hard masses that form in the urinary tract and may cause pain, bleeding, or an infection or block of the flow of urine. Tiny stones may cause no symptoms, but larger stones… read more structural abnormalities, or other causes of urinary obstruction.
New Treatment Could Ease The Passage Of Kidney Stones
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Every year, more than half a million Americans visit the emergency room for kidney stone problems. In most cases, the stones eventually pass out of the body on their own, but the process can be excruciatingly painful.
Researchers at MIT and Massachusetts General Hospital have now devised a potential treatment that could make passing kidney stones faster and less painful. They have identified a combination of two drugs that relax the walls of the ureter the tube that connects the kidneys to the bladder and can be delivered directly to the ureter with a catheter-like instrument.
Relaxing the ureter could help stones move through the tube more easily, the researchers say.
We think this could significantly impact kidney stone disease, which affects millions of people, says Michael Cima, the David H. Koch Professor of Engineering in MITs Department of Materials Science and Engineering, a member of MITs Koch Institute for Integrative Cancer Research, and the senior author of the study.
Local drug delivery
Ureteral relaxation
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Types Of Uti And Treatment Implications
The comments that follow focus on urethritis, cystitis, and pyelonephritis. The management of asymptomatic bacteriuria, chronic Foley catheterârelated bacteriuria, and prostatitis is not discussed.
A long-standing issue is whether UTI represent surface mucosal or parenchymal infections or both. Infections of the urethra are viewed as superficial, whereas pyelonephritis is considered a parenchymal infection. Cystitis ranges from mild to invasion of the wall of the bladder. So, which is more important: Adequate urine or serum concentrations of antimicrobial agents?
Data from UTI in animal models are helpful. High urine drug concentrations are necessary to sterilize urine for pyelonephritis, it is necessary to have effective tissue concentrations of the antimicrobial agent. The serum concentrations of anti-infectives correlate with the drug concentration in renal tissue . Glomerular filtration ± net tubular secretion determines urine concentration. Thus, for patients who have renal insufficiency with therapeutic serum drug levels and adequate arterial perfusion of the renal parenchyma, the delivery of therapeutic drug concentrations to both the parenchyma and the urine should not be a problem. For patients with chronic insufficiency and cystitis, there is a possibility that the urine drug concentration may be too low to eradicate the etiologic organism.
Can A Large Kidney Stone Cause An Injury
Your risk of injury from a kidney stone can go up based on the size and location of the stone. A larger stone could get stuck in a ureter, causing pressure to build up. This can lead to renal failure and, in the worst-case scenario, you could lose your kidney. The chance of passing a 1 cm stone is less than 10%, and stones larger than 1 cm typically dont pass.
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Study Recommendations And Future Research
Scientists already knew that antibiotics alter the composition of the human microbiome the community of microorganisms in the body. Disruptions in the intestinal microbiome have been linked to the occurrence of kidney stones, but no previous studies revealed an association between antibiotic usage and stones.
The new findings reinforce the need for clinicians to promote antibiotic stewardship and be careful in prescribing correct antibiotics. They suggest that antibiotic prescription practices may represent a modifiable risk factor a change in prescribing patterns might decrease the current epidemic of kidney stones in children. One co-author of the current paper, Jeffrey Gerber, MD, PhD, is an infectious diseases specialist at CHOP who leads programs in antibiotic stewardship an approach that guides healthcare providers in prescribing the most appropriate antibiotic for each patients specific infection, with the aims of improving individual outcomes and reducing the overall risk of antibiotic resistance.
The study team is continuing to investigate the microbiomes of children and adolescents with kidney stones in a single-center study at CHOP. Its goal is to expand this research into broader, population-based studies to better understand how variations in microbiome composition may influence the development of kidney stones and how to reduce or prevent them.
Next Steps
Other Urinary Tract Antibiotics
There are other prescription antibiotics that may be administered for urinary tract infections however are not specifically for treating kidney infections. For example, Macrobid is particularly for dealing with bladder infections and must not be used for kidney infections although it minimizes the growth of bacteria in similar ways that kidney infection antibiotics will. Make certain you consult your physician to verify where the infection is located along the urinary tract prior to deciding in between macrobid or kidney infection prescription antibiotics.
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Types Of Kidney Stones
There are four major types of kidney stones, including:
- stones formed from calcium not used by the bones and muscles, combined with oxalate or phosphate these are the most common kidney stones
- stones containing magnesium and the waste product ammonia these are called struvite stones and form after urine infections
- uric acid stones these are often caused by eating very large amounts of protein foods
- cystine stones these are rare and hereditary.
Which Antibiotic Will Work Best
Your doctor will take a urine sample to confirm that you have a UTI. Then the lab will grow the germs in a dish for a couple of days to find out which type of bacteria you have. This is called a culture. Itâll tell your doctor what type of germs caused your infection. Theyâll likely prescribe one of the following antibiotics to treat it before the culture comes back:
Which medication and dose you get depends on whether your infection is complicated or uncomplicated.
âUncomplicatedâ means your urinary tract is normal. âComplicatedâ means you have a disease or problem with your urinary tract. You could have a narrowing of your ureters, which are the tubes that carry urine from your kidneys to your bladder, a narrowing in the urethra which transports urine from the bladder out of the body, or, you might have a blockage like a kidney stone or an enlarged prostate . It’s also possible you have a urinary fistula or a bladder diverticulum.
To treat a complicated infection, your doctor might prescribe a higher dose of antibiotics. If your UTI is severe or the infection is in your kidneys, you might need to be treated in a hospital or doctor’s office with high-dose antibiotics you get through an IV.
Your doctor will also consider these factors when choosing an antibiotic:
- Are you over age 65?
- Are you allergic to any antibiotics?
- Have you had any side effects from antibiotics in the past?
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Can Online Doctors Write Prescriptions For Kidney Infections
Yes, our doctors write prescriptions for kidney infections for patients who qualify. Antibiotics are the first line of kidney infection treatment. Common antibiotics for kidney infection that our doctors may prescribe if you qualify include: Amoxicillin, Bactrim, Cephalexin, Cipro, and Clindamycin.
Request medicine for kidney infection through an online medical consultation with a doctor here.
Whos Most Likely To Get Kidney Stones What Are The Risk Factors
White men in their 30s and 40s are most likely to get kidney stones. However, anyone can develop kidney stones.
There are several risk factors for developing kidney stones. These include:
- Not drinking enough liquids.
- Having a diet that includes the substances that form the stones .
- Having a family history of kidney stones.
- Having a blockage in your urinary tract.
Certain medical conditions can also increase your risk of developing stones. This is because they may increase or decrease levels of the substances that make up a kidney stone. These conditions can include:
- Hypercalciuria .
Certain foods can also place you at risk of a kidney stone. These foods include:
- Meats and poultry .
- Sodium .
- Sugars .
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Where Do Kidney Stones Come From
Kidney stones form develop when certain substances, such as calcium, oxalate, and uric acid, become concentrated enough to form crystals in your kidneys. The crystals grow larger into “stones.” About 80% to 85% of kidney stones are made of calcium. The rest are uric acid stones, which form in people with low urine pH levels.
After stones form in the kidneys, they can dislodge and pass down the ureter, blocking the flow of urine. The result is periods of severe pain, including flank pain , sometimes with blood in the urine, nausea, and vomiting. As the stones pass down the ureter toward the bladder, they may cause frequent urination, bladder pressure, or pain in the groin.
“If you experience any of these symptoms, see your primary care physician,” says Dr. Eisner. “He or she will likely perform a urinalysis and a renal ultrasound, abdominal x-ray, or CT scan to confirm kidney stones are the source of your pain and determine their size and number.”
What Is A Kidney Stone
A kidney stone is a hard object that is made from chemicals in the urine. There are four types of kidney stones: calcium oxalate, uric acid, struvite, and cystine. A kidney stone may be treated with shockwave lithotripsy, uteroscopy, percutaneous nephrolithomy or nephrolithotripsy. Common symptoms include severe pain in lower back, blood in your urine, nausea, vomiting, fever and chills, or urine that smells bad or looks cloudy.
Urine has various wastes dissolved in it. When there is too much waste in too little liquid, crystals begin to form. The crystals attract other elements and join together to form a solid that will get larger unless it is passed out of the body with the urine. Usually, these chemicals are eliminated in the urine by the body’s master chemist: the kidney. In most people, having enough liquid washes them out or other chemicals in urine stop a stone from forming. The stone-forming chemicals are calcium, oxalate, urate, cystine, xanthine, and phosphate.
After it is formed, the stone may stay in the kidney or travel down the urinary tract into the ureter. Sometimes, tiny stones move out of the body in the urine without causing too much pain. But stones that don’t move may cause a back-up of urine in the kidney, ureter, the bladder, or the urethra. This is what causes the pain.
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How Long Does It Take A Kidney Stone To Form
You can have kidney stones for years without knowing theyre there. As long as these stones stay in place within your kidney, you wont feel anything. Pain from a kidney stone typically starts when it moves out of your kidney. Sometimes, a stone can form more quickly within a few months.
Talk with your healthcare provider about your risk factors. They might do a 24-hour urine test to check how quickly you develop stones.
Should I Cut Calcium Out Of My Diet If I Develop Calcium Oxalate Kidney Stones
If you develop kidney stones composed of calcium, you may be tempted to stop eating foods that include calcium. However, this is the opposite of what you should do. If you have calcium oxalate stones, the most common type, its recommended that you have a diet higher in calcium and lower in oxalate.
Foods that are high in calcium include:
- Cows milk.
Its also important to drink plenty of fluids to dilute the substances in your urine.
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When To See A Doctor
In many cases, small kidney stones can pass on their own and dont require any treatment.
If youre able to manage your pain with over-the-counter medications and dont have any signs of infection or severe symptoms like nausea or vomiting, you may not need treatment.
However, if you experience any of the following symptoms, you should seek immediate medical attention:
- blood in the urine
How Are Kidney Stones Treated
Once diagnosed, your healthcare provider will first determine if you even need treatment. Some smaller kidney stones may leave your system when you urinate. This can be very painful. If your provider decides that you do need treatment, your options include medications and surgery.
Medications. Medications may be prescribed to:
- Your healthcare provider may recommend that you take an over-the-counter medication like ibuprofen or, if youre in the emergency room, an IV narcotic.
- Manage nausea/vomiting.
- Relax your ureter so that the stones pass. Commonly prescribed medicines include tamsulosin and nifedipine .
You should ask your healthcare provider before you take ibuprofen. This drug can increase the risk of kidney failure if taken while youre having an acute attack of kidney stones especially in those who have a history of kidney disease and associated illnesses such as diabetes, hypertension and obesity.
Surgery. There are four types of surgeries used to treat kidney stones. The first three are minimally invasive, meaning that the surgeon enters your body through a natural opening , or makes a small incision.
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Use Nonaspirin Pain Relievers
Nonaspirin pain relievers can help relieve discomfort. Ibuprofen and acetaminophen can also help break fevers caused by the infection.
However, note that if you have kidney dysfunction, or acute kidney injury, as a result of a kidney infection, its important to avoid nonsteroidal anti-inflammatory drugs , such as ibuprofen and naproxen .
How Do Health Care Professionals Treat Kidney Infections
If you have a kidney infection, a health care professional will prescribe antibiotics. Even before your test results are in, the health care professional may prescribe an antibiotic that fights the most common types of bacteria. Although you may feel relief from your symptoms, make sure to take the entire antibiotic treatment that your health care professional prescribes.
Once your lab results are in, the health care professional may switch the antibiotic to one that better treats the type of infection you have. You may take these antibiotics by mouth, through a vein in your arm, called by IV, or both.
If you are very sick from your kidney infection, you may go to a hospital for bed rest. A health care professional may give you fluids through an IV.
If something such as a kidney stone or an enlarged prostate is blocking your urinary tract, a doctor can sometimes treat the problem with surgery or another procedure.
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