Be aware of the risk of drug-induced kidney stones and take appropriate steps to prevent or treat their occurrence

Abstract

Drug-induced kidney stones can form when poorly soluble drugs with high levels of renal excretion (e.g. protease inhibitors and sulfonamides) crystallise in the urine, as well as when drugs with metabolic effects (e.g. calcium + vitamin D supplements and carbonic anhydrase inhibitors) promote the crystallisation of metabolic compounds. Methods such as infrared spectroscopy and X-ray diffraction should be used to determine whether a drug or its metabolites are present in stones or crystals, while a careful clinical inquiry is necessary to successfully distinguish between common calculi and metabolically-induced stones. Kidney stones can often be prevented or treated through the modification of risk factors, such as urine output.