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Urolithiasis with topiramate in nonambulatory children and young adults

Monisha Goyal1, Richard I Grossberg, Mary Ann O'Riordan

  • 1Pediatric Neurology Department, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio, USA. Monisha.Goyal@uhhospitals.org

Pediatric Neurology
|March 24, 2009
PubMed

Insights

Topiramate, an antiepileptic drug, significantly increases kidney stone risk in neurologically impaired individuals. This population experienced a 54% urolithiasis rate, much higher than previously reported.

Area of Science:

  • Nephrology
  • Neurology
  • Pharmacology

Background:

  • Urolithiasis is uncommon in children, often linked to metabolic factors.
  • Topiramate, an antiepileptic, has a known 1.5% kidney stone risk in clinical trials.
  • This risk may be elevated in specific patient groups with pre-existing conditions.

Purpose of the Study:

  • To investigate the incidence of urolithiasis in nonambulatory, neurologically impaired individuals.
  • To assess the association between topiramate use and kidney stone development in this high-risk population.

Main Methods:

  • Retrospective review of patients in a long-term care facility.
  • Categorization into three groups: no antiepileptic drugs, non-topiramate antiepileptics, and topiramate users.
  • Analysis of clinical urolithiasis development over a mean of 36.4 months.

Main Results:

  • Thirteen out of 24 (54%) individuals on topiramate developed urolithiasis.
  • This incidence is substantially higher than the general reported risk of 1.5%.

Conclusions:

  • Nonambulatory and neurologically impaired individuals in long-term care are at a significantly increased risk of topiramate-associated urolithiasis.
  • Clinical vigilance for kidney stones is crucial in this population undergoing topiramate treatment.

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