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Drug-Induced Nephrolithiasis

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Diagnosis and Management of Pediatric Nephrolithiasis

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Abstract

Drug-induced nephrolithiasis is a rare but important cause of kidney stones in pediatric patients. There are two major mechanisms wherein drugs can cause nephrolithiasis. The first is by direct crystallization of a poorly soluble drug or its metabolites. The second is via the induction of metabolic effects that promote calculi formation. Antimicrobials (sulfonamides and protease inhibitors in particular) are the class most implicated in direct crystallization. High doses of the drug and prolonged treatment time are additional factors that can contribute to direct crystallization. Drugs that act as metabolic promoters modify the urinary environment leading to precipitation of molecules needed for calculi formation, such as calcium, phosphate, or uric acid. In the pediatric population anticonvulsants and diuretics are the main culprits. Given its rarity, a careful medical history is essential to the correct identification of drug-induced nephrolithiasis to ensure appropriate and directed treatment decisions.

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Authors and Affiliations

  1. Division of Nephrology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Rushelle Byfield & Lawrence Copelovitch

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  1. Rushelle Byfield
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  2. Lawrence Copelovitch
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Correspondence to Rushelle Byfield .

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Editors and Affiliations

  1. Department of Pediatrics, Division of Nephrology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Neil J. Paloian

  2. Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Kristina L. Penniston

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Byfield, R., Copelovitch, L. (2022). Drug-Induced Nephrolithiasis. In: Paloian, N.J., Penniston, K.L. (eds) Diagnosis and Management of Pediatric Nephrolithiasis. Springer, Cham. https://doi.org/10.1007/978-3-031-07594-0_5

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  • DOI: https://doi.org/10.1007/978-3-031-07594-0_5

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