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Incidence of kidney stones with topiramate treatment in pediatric patients
Adel A H Mahmoud1, Tamer Rizk, Nahid K El-Bakri
1Pediatric Neurology Department, Neurosciences Center, Riyadh, Saudi Arabia. amahmoud10@yahoo.ca
Insights
Long-term topiramate (TPM) therapy in children may increase the risk of developing kidney stones. Routine ultrasounds are recommended to monitor urinary system health during TPM treatment.
Area of Science:
- Pediatric Neurology
- Nephrology
- Pharmacology
Background:
- Topiramate (TPM) is an anticonvulsant medication used in pediatric patients.
- The potential for TPM to cause kidney stones (nephrolithiasis) requires investigation in this population.
Purpose of the Study:
- To determine the incidence of nephrolithiasis in children undergoing long-term topiramate therapy (≥1 year).
Main Methods:
- Retrospective observational study of 96 children on TPM therapy.
- Inclusion criteria: normal baseline renal ultrasound, TPM therapy for ≥1 year.
- Exclusion criteria: chronic illnesses, nephrotoxic medications, non-compliance.
Main Results:
- Five out of 96 children (5.2%) developed kidney stones.
- Kidney stone incidence was higher in females (80%) than males (20%).
- The difference in incidence between genders was not statistically significant (p > 0.05).
Conclusions:
- Long-term topiramate use is associated with an increased incidence of asymptomatic kidney stones in children.
- Routine baseline and follow-up renal ultrasounds are recommended for pediatric patients on topiramate therapy.
Purpose:
We ran this study to assess the incidence of nephrolithiasis in a group of children on topiramate (TPM) therapy for at least 1 year.
Methods:
In this retrospective observational surveillance study, we reviewed the medical charts of children on TPM for at least 1 year seen at the pediatric neurology department during the period from 2005 to 2010 at King Fahad Medical City. Children with a normal baseline ultrasound report were included. Follow-up ultrasound reports after at least 1 year were collected. However, patients with any evidence of chronic illness or medications that may affect the kidney functions in addition to those who are not compliant with the prescribed dose were excluded. Family history of renal stones, symptoms suggestive of urologic disorders, and comorbidities were recorded.
Key Findings:
Medical charts of 96 children on TPM with a mean age of 6.9 (±3.8) years were reviewed; 52 (54.2%) of the children were male. The follow-up ultrasound showed that five children (5.2%) had developed kidney stones. The occurrence of kidney stones was found in four female patients (80%) versus one male (20%) (p > 0.05).
Significance:
Long-term use of TPM may result in increased incidence of asymptomatic kidney stones in the pediatric population. Hence, routine baseline and follow-up ultrasound of the urinary system should be recommended during the use of TPM in children.
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