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Hypercalciuria following ceftriaxone a fact or myth
Anoush Azarfar1, Mohammad Esmaeeli1, Yalda Ravanshad2
1Department of Pediatric Nephrology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
Ceftriaxone, a common antibiotic, did not significantly increase urinary calcium excretion in children within three days. This study found no difference in calcium excretion rates between children receiving ceftriaxone and those who did not.
Area of Science:
- Pediatric Nephrology
- Pharmacology
- Clinical Research
Background:
- Nephrolithiasis is a prevalent global health issue affecting both pediatric and adult populations.
- Ceftriaxone, a frequently prescribed antibiotic, has been implicated in contributing to renal stone formation and hypercalciuria.
Purpose of the Study:
- To investigate the impact of ceftriaxone on urinary calcium excretion rates in pediatric patients.
- To determine if ceftriaxone administration alters calcium levels in children's urine.
Main Methods:
- A randomized study involving 84 healthy children over 3 months old hospitalized for non-renal conditions.
- Participants were divided into two groups: one receiving ceftriaxone and a control group not receiving antibiotics.
- Urinary calcium excretion was measured as the calcium to creatinine ratio on days 1 and 3 of admission.
Main Results:
- On the first day, mean calcium excretion was similar between groups (0.13 ± 0.06 vs. 0.14 ± 0.02, P=0.1).
- After three days, urinary calcium to creatinine ratio increased in both groups but showed no significant difference (0.27 ± 0.2 vs. 0.26 ± 0.08, P=0.8).
Conclusions:
- Urinary calcium excretion approximately doubles within a short period post-admission, potentially due to conditions like gastroenteritis.
- Ceftriaxone does not appear to uniquely increase urinary calcium excretion compared to other antibiotics within a three-day period in children.
Introduction:
Nephrolithiasis is a common worldwide problem both in children and adults. Ceftriaxone as a widely used antibiotic can contribute to the formation of renal stones and hypercalciuria.
Objectives:
To find the effect of ceftriaxone, a widely used antibiotic, on urinary calcium excretion rate in children.
Patients And Methods:
84 infants and children over 3 months admitted to hospital for non-renal problems. They were all previously healthy children affected with a condition mandating hospitalisation. They were randomly divided into 2 groups; those who received ceftriaxone according to their physician decision as the case group and those who did not receive antibiotics as the control group. The patients urinary calcium excretion was determined as calcium to creatinine ratio in a random urine sample in the first and third day of their admission. All data was expressed by mean ± SD and analysed by t independent and chi-square tests by SPSS 16. P P value less than 0.05 was significant.
Results:
Eighty-four cases were analysed. Calcium excretion in received and non-received ceftriaxone groups was 0.13 ± 0.06 and 0.14 ± 0.02 respectively at first day of admission ( P = 0.1). After 3 days, the urine calcium to creatinine ratio increased to 0.27 ± 0.2 and 0.26 ± 0.08 in received and non- received ceftriaxone groups ( P = 0.8).
Conclusion:
In children, urinary calcium excretion increases 2 times in average in a short time after admission because of gastroenteritis, and ceftriaxone is not different to other antibiotics for increase urinary calcium excretion in 3 days after admission.
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