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Calcium nephrolithiasis induced by topiramate
Sergio Merino-Salas1, Miguel Angel Arrabal-Polo2, Maria del Carmen Cano-Garcia3
1Servicio de Urologia.Hospital de Poniente.El Ejido.Almeria. Spain.
Archivos Espanoles De Urologia
|May 21, 2014
Summary
Topiramate can cause kidney stones (nephrolithiasis) in women, often due to metabolic changes like alkaline urine and low citrate. Monitoring and preventative measures are crucial for patients on this medication.
Area of Science:
- Neurology
- Nephrology
- Pharmacology
Background:
- Topiramate, an anticonvulsant, is increasingly used for neurological conditions and chronic pain management.
- Its efficacy in pain and mood stabilization is recognized, but potential side effects require attention.
Observation:
- Four cases of topiramate-induced nephrolithiasis in women treated for pain and mood stabilization (250-300 mg/day) were observed between 2006-2012.
- The kidney stones were composed of calcium phosphate (apatite) and/or oxalate.
- Metabolic alterations included alkaline urine pH and hypocitraturia.
Findings:
- Topiramate treatment was associated with the development of nephrolithiasis.
- Alkaline urine and hypocitraturia were the most frequent metabolic disturbances.
- Mixed tubular acidosis is a potential risk factor.
Implications:
- Patients initiating topiramate therapy require proactive monitoring for nephrolithiasis.
- Preventative strategies, including increased fluid and potassium citrate intake, may mitigate risks.
- Understanding these risks is vital for safe and effective topiramate use in pain and mood management.
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