From the Guidelines
Corticosteroids, such as cortisone, may increase the risk of kidney stone recurrence in some patients, particularly with long-term or high-dose use, by affecting calcium metabolism and increasing urinary calcium excretion 1. The relationship between corticosteroids and kidney stone recurrence is complex and involves the medication's impact on calcium homeostasis. Key points to consider include:
- The effect of corticosteroids on calcium metabolism, leading to increased urinary calcium excretion (hypercalciuria) and decreased calcium absorption from the intestines, which can create conditions favorable for stone formation 1.
- The dose-dependent nature of this risk, with higher doses and longer durations of corticosteroid use potentially increasing the likelihood of kidney stone development 1.
- The importance of monitoring urinary calcium levels and considering preventive measures, such as dietary modifications (e.g., reducing sodium and animal protein intake) or medications like thiazide diuretics, to mitigate the risk of stone recurrence in patients taking corticosteroids 1.
- The underlying mechanism involves corticosteroids interfering with vitamin D metabolism and calcium homeostasis, leading to altered calcium handling by the kidneys 1.
Given the potential increased risk, patients taking corticosteroids, especially those with a history of kidney stones, should stay well-hydrated by drinking at least 2-3 liters of water daily and discuss preventive measures with their doctor 1.
From the Research
Corticosteroid and Kidney Stone Recurrence
- There is no direct evidence in the provided studies to suggest that corticosteroid (cortisone) increases the recurrence of kidney stones (nephrolithiasis) 2, 3, 4, 5, 6.
- The studies focus on the prevention of kidney stone recurrence through pharmacologic and dietary measures, such as increasing fluid intake, adjusting dietary recommendations, and using medications like thiazide, potassium alkali, and allopurinol 2, 3, 4, 5.
- One study discusses the role of calcium in the prevention of kidney stones, suggesting that increased dietary calcium may reduce the risk of the first kidney stone, but notes that more research is needed to understand the effect of calcium on stone formation 6.
- None of the studies mention corticosteroid as a factor in kidney stone recurrence, indicating a lack of research on this specific topic 2, 3, 4, 5, 6.