Antibiotics and Kidney Stones: Perturbation of the Gut-Kidney Axis.
Antibiotics and Kidney Stones: Perturbation of the Gut-Kidney Axis.
复制标题
抗生素和肾结石：肠肾轴的扰动。
DOI：
10.1053/j.ajkd.2019.07.021
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Lange,Dirk
中科院分区：
文献类型：
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作者：
Tasian,Gregory;Miller,Aaron;Lange,Dirk
在美国，肾结石疾病的累积发病率在15年内翻了一番，其患病率现在相当于糖尿病。1、2这种无法解释的发病率急剧上升对儿童和年轻妇女造成了不成比例的影响。1，3肾结石是一种矿物质代谢紊乱，与慢性肾脏疾病、4、5骨折、6和高血压的风险增加有关。5、7个肾结石患者也有复发痛性肾结石事件的高风险，8、9其中一些患者需要手术，并与肾衰竭和死亡的风险增加相关。10由于肾结石流行病学的迅速变化，研究人员将重点放在确定肾结石疾病的新决定因素上，包括抗生素及其对肠道和尿液微生物组组成的影响。2011年，美国开出了2.62亿个疗程的抗生素，其中10岁以下儿童和妇女的处方率最高。1130%的患者每年至少开一种抗生素。12在这一期的AJKD中，Ferraro等人13报道了在护士健康研究(NHS)I和II队列中，先前接触抗生素与女性中发生症状性肾结石有关。这项研究的优势包括预期收集的抗生素暴露情况，以及对一部分参与者来说，24小时尿液化学测试结果的可用性。
The cumulative incidence of kidney stone disease in the United States has doubled over 15 years, and its prevalence is now equivalent to that of diabetes. 1, 2 This dramatic and unexplained increase in incidence has disproportionately affected children and young women. 1, 3 Nephrolithiasis is a disorder of mineral metabolism that is associated with increased risk for chronic kidney disease, 4, 5 fracture, 6 and hypertension. 5, 7 Individuals with nephrolithiasis also have a high risk for recurrent painful kidney stone events, 8, 9 some of which require surgery and are associated with increased risk for kidney failure and death. 10Due the rapid shift in the epidemiology of nephrolithiasis, investigators have focused on identifying novel determinants of kidney stone disease, including antibiotics and their impact on the intestinal and urinary microbiome composition. In 2011 in the United States, 262 million courses of antibiotics were prescribed, with the highest rates of prescription for children younger than 10 years and women. 11 Thirty percent of patients are prescribed at least 1 antibiotic annually. 12 In this issue of AJKD, Ferraro et al13 reported that prior antibiotic exposure is associated with incident symptomatic kidney stones among women in the well-characterized Nurses’ Health Study (NHS) I and II cohorts. Strengths of the study include prospectively collected antibiotic exposures and, for a subset of participants, availability of 24-hour urine chemistry test results.