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Ceftriaxone crystallization and its potential role in kidney stone formation
Somchai Chutipongtanate1, Visith Thongboonkerd
1Medical Proteomics Unit, Office for Research and Development, Faculty of Medicine Siriraj Hospital, and Center for Research in Complex Systems Science, Mahidol University, Bangkok, Thailand.
Biochemical and Biophysical Research Communications
|February 19, 2011
Summary
Ceftriaxone antibiotic can crystallize in urine with calcium, potentially causing kidney stones. These drug-induced crystals may adhere to kidney cells, contributing to nephrolithiasis.
Area of Science:
- Nephrology
- Pharmacology
- Crystallography
Background:
- Drug-induced nephrolithiasis accounts for 1-2% of renal calculi.
- Understanding the mechanisms of antibiotic-induced kidney stones is crucial.
Purpose of the Study:
- To investigate ceftriaxone crystallization in urine.
- To explore ceftriaxone's role in kidney stone formation.
Main Methods:
- Ceftriaxone sodium mixed with calcium chloride in deionized water or artificial urine.
- Crystallization observed under polarized microscopy.
- Calcium-depletion assay to assess calcium requirement.
Main Results:
- Ceftriaxone crystallized with free calcium in a dose- and time-dependent manner.
- Ceftriaxone/calcium crystals exhibited birefringence and varied shapes (needle, star-burst, irregular-plate).
- Crystals adhered to renal tubular cells, suggesting a pathogenic role.
Conclusions:
- Ceftriaxone crystallizes in urine under physiological conditions.
- Tubular occlusion and crystal-cell adhesion are potential mechanisms for ceftriaxone-induced nephrolithiasis.
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