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Acute kidney injury caused by ceftriaxone-induced urolithiasis in children: a single-institutional experience in diagnosis, treatment and follow-up

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Abstract

Purpose

To evaluate our clinical outcomes in managing acute kidney injury (AKI) resulting from ceftriaxone-induced urolithiasis with emergency treatment.

Methods

From July 2008 to July 2013, a series of 15 patients including 12 males and 3 females were admitted to our center. The mean age of them was (4.76 ± 3.74) years. A chief complaint of anuria was presented in 12 (80.0 %) patients for 13 h–4 days and that of oliguria in three (20.0 %) patients for 20 h–10 days. All of them were diagnosed of postrenal AKI resulting from ceftriaxone-induced urolithiasis and underwent emergency hospitalization.

Results

Double-J stenting with cystoscopy was successfully performed in nine patients (60.0 %), and ureteroscopy was applied in four patients (26.7 %). One patient (6.7 %) underwent unilateral double-J insertion combined with contralateral percutaneous nephrostomy, and one (6.7 %) underwent open surgery. Loose texture and sandlike stones, the main characteristics of these stones, made them excreted spontaneously after the initial treatment, whereas only one patient (6.7 %) underwent additional ureterolithotomy due to many residual calculi. Serum creatinine and blood urea nitrogen recovered to normal levels within 3 days. All specimens were collected and analyzed by infrared spectrum, with results demonstrating that the main composition was ceftriaxone calcique. All patients were followed up for 11 months–5 years (mean 33.80 ± 22.56 months). No one turned to irreversible renal failure.

Conclusions

Ceftriaxone could result in urolithiasis in children, which could also cause AKI. Appropriate and timely surgical management by conventional treatments will mostly lead to full recovery of renal functions.

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Abbreviations

AKI:

Acute kidney injury

URS:

Ureteroscopy

PCN:

Percutaneous nephrostomy

CT:

Computed tomography

Cr:

Serum creatinine

BUN:

Blood urea nitrogen

CRRT:

Continuous renal replacement therapy

References

  1. Sharon PA (2009) Acute kidney injury in children. Pediatr Nephrol 24:253–263

    Article  Google Scholar 

  2. Vomiero G, Carpenter B, Robb I, Filer G (2002) Combination of ceftriaxone and acyclovir—an underestimated nephrotoxic potential? Pediatr Nephrol 17:633–637

    Article  PubMed  Google Scholar 

  3. Shokeir AA, Shoma AM, Abubieh EA, Nasser MA, Eassa W, EI-Asmy A (2002) Recoverability of renal function after relief of acute complete ureteral obstruction: clinical prospective study of the role of renal resistive index. Urology 59:506–510

    Article  PubMed  Google Scholar 

  4. Mehta RL, Kellum JA, Shal SV, Molitoris BA, Ronco C, Warnock DG, Levin A (2007) Acute kidney injury network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 11:R31

    Article  PubMed  PubMed Central  Google Scholar 

  5. Jia J, Shen X, Wang L, Zhang T, Xu M, Fang X, Xu G, Qian C, Wu Y, Geng H (2013) Extracorporeal shock wave lithotripsy is effective in treating single melamine induced urolithiasis in infants and young children. J Urol 189:1498–1502

    Article  PubMed  Google Scholar 

  6. Schaad UB, Wedgwood-Krucko J, Tschaeppeler H (1988) Reversible ceftriaxone-associated biliary pseudolithiasis in children. Lancet 2:1411–1413

    Article  PubMed  CAS  Google Scholar 

  7. Prince JS, Senac MO Jr (2003) Ceftriaxone-associated nephrolithiasis and biliary pseudolithiasis in a child. Pediatr Radiol 33:648–651

    Article  PubMed  Google Scholar 

  8. Akl KF, Masri AT, Hjazeen MM (2011) Acute urine retention induced by ceftriaxone. Saudi J Kidney Dis Transpl 22:1226–1228

    PubMed  Google Scholar 

  9. Lu X, Wu R, Huang X, Zhang Y (2012) Noncontrast multidetector-row computed tomography scanning for detection of radiolucent calculi in acute renal insufficiency caused by bilateral ureteral obstruction of ceftriaxone crystals. J Xray Sci Technol 20:11–16

    PubMed  Google Scholar 

  10. Boffa JJ, De Preneuf H, Bouadma L, Daudon M, Pallot JL (2000) Acute renal failure after amoxicillin crystallization. Presse Med 8:699–701

    Google Scholar 

  11. Kimata T, Kaneko K, Takahashi M, Hirabayashi M, Shimo T, Kino M (2012) Increased urinary calcium excretion caused by ceftriaxone: possible association with urolithiasis. Pediatr Nephrol 27:605–609

    Article  PubMed  Google Scholar 

  12. Kapur G, Valentini RP, Mattoo TK, Warrier I, Imam AA (2008) Ceftriaxone induced hemolysis complicated by acute renal failure. Pediatr Blood Cancer 50:139–142

    Article  PubMed  Google Scholar 

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Correspondence to Hongquan Geng.

Additional information

Xiaowei Shen and Wang Liu contributed equally to this work.

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Shen, X., Liu, W., Fang, X. et al. Acute kidney injury caused by ceftriaxone-induced urolithiasis in children: a single-institutional experience in diagnosis, treatment and follow-up. Int Urol Nephrol 46, 1909–1914 (2014). https://doi.org/10.1007/s11255-014-0742-x

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  • DOI: https://doi.org/10.1007/s11255-014-0742-x

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