Publication: Ceftriaxone crystallization and its potential role in kidney stone formation
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Issued Date
2011-03-18
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ISSN
10902104
0006291X
0006291X
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2-s2.0-79952738342
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Mahidol University
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SCOPUS
Bibliographic Citation
Biochemical and Biophysical Research Communications. Vol.406, No.3 (2011), 396-402
Suggested Citation
Somchai Chutipongtanate, Visith Thongboonkerd Ceftriaxone crystallization and its potential role in kidney stone formation. Biochemical and Biophysical Research Communications. Vol.406, No.3 (2011), 396-402. doi:10.1016/j.bbrc.2011.02.053 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/11577
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Title
Ceftriaxone crystallization and its potential role in kidney stone formation
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Abstract
Drug-induced nephrolithiasis contributes to 1-2% of the incidence of renal calculi. We examined whether ceftriaxone at therapeutic doses could be crystallized in the urine and also explored its role in kidney stone formation. Crystallization was induced by mixing ceftriaxone sodium at therapeutic urinary excretion levels (0.5-4.0. mg/ml) to calcium chloride at physiologic urinary concentration (5. mM) in deionized (dI) water or artificial urine (AU). The results showed that ceftriaxone was crystallized with free calcium in dose- and time-dependent manner. These ceftriaxone/calcium crystals showed birefringence property under polarized microscope. Individual crystals had needle-shape (5-100μm in length), whereas the aggregated form had star-burst and irregular-plate shape (40-200μm in diameter) (note that the crystal sizes were much larger than renal tubular lumens). Calcium-depletion assay revealed that crystallization required free calcium as a substrate. In AU, crystallization remained although it was partially inhibited when compared to that in dI water. Finally, these crystals could tightly adhere onto renal tubular cell surface. Our data demonstrated that ceftriaxone at therapeutic levels could be crystallized with free calcium in the urine under physiologic condition. We hypothesize that tubular occlusion and crystal-cell adhesion may play important role in pathogenic mechanisms of ceftriaxone-induced nephrolithiasis. © 2011 Elsevier Inc.