Triamterene and renal lithiasis: a review

Area of Science:

• Nephrology
• Pharmacology
• Urology

Background:

• Triamterene (TAT) is a diuretic medication.
• Renal calculi (kidney stones) can form in patients using TAT.
• These calculi may contain TAT and its metabolites, sometimes with a protein matrix.

Purpose of the Study:

• To investigate the formation of renal calculi in patients treated with triamterene.
• To understand the composition and incidence of TAT-containing kidney stones.
• To identify potential risk factors for calculus formation during TAT therapy.

Main Methods:

• Analysis of renal calculi composition in patients using triamterene.
• Epidemiological assessment of calculus incidence in TAT therapy.
• Evaluation of patient history for renal calculi and family history.

Main Results:

• A small subset of patients (1 in 1,500 to 1 in 2,000) develop TAT-containing renal calculi.
• Calculi composition varies; some consist solely of TAT, metabolites, and protein.
• No established dose-effect or duration-of-therapy correlation with renal lithiasis was found.
• Patients with prior stone formation or family history showed similar rates of calculus development with or without TAT.
• Abnormal TAT absorption, excretion, or metabolism was not observed in patients forming these calculi.

Conclusions:

• Triamterene (TAT) can contribute to renal calculi formation in a small patient population.
• Calculus formation appears linked to drug binding with a protein matrix.
• Risk factors like dosage, duration of therapy, and individual metabolic differences do not strongly correlate with TAT-induced calculi formation.