Calcium nephrolithiasis induced by topiramate.
Topiramate is an approved drug to treat seizures, but its indications have been extended to other diseases of the nervous system and as an adjuvant to chronic pain. We present four cases of topiramate-induced nephrolithiasis from 2006-2012 in women whose treatment was prescribed for pain control and as a mood stabilizer at doses of 250-300 mg/day. In two cases, the lithiasis was caused by calcium phosphate (patite) and in the other two cases by oxalate and calcium phosphate. The most common metabolic alteration was an alkaline pH, followed by hypocitraturia. The drug was discontinued in two patient; it was reduced in one and was maintained in the fourth. An increase in fluid and potassium citrate intake was prescribed. In patients starting treatment with topiramate, an adequate control and prevention of nephrolithiasis should be performed due to the risk of mixed tubular acidosis and hypocitraturia. to the risk of mixed tubular acidosis and hypocitraturia.
Servicio de Urologia.Hospital de Poniente.El Ejido.Almeria. Spain.
Sergio
S
Merino-Salas
Servicio de Urologia.Hospital Universitario San Ceciclio. Granada. Spain.
Miguel Angel
MA
Arrabal-Polo
Servicio de Urologia.Hospital Universitario Morales Meseguer. Murcia.Spain.
Maria del Carmen
Mdel C
Cano-Garcia
Servicio de Urologia.Hospital Universitario San Ceciclio. Granada. Spain.
Miguel
M
Arrabal-Martin
D000328:Adult; D000368:Aged; D000700:Analgesics / Q000009:adverse effects*; D002129:Calcium Oxalate / Q000378:metabolism; D002130:Calcium Phosphates / Q000378:metabolism; D059350:Chronic Pain / Q000188:drug therapy; D019343:Citric Acid / Q000652:urine; D005260:Female; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D053565:Hypercalciuria / Q000139:chemically induced*; D007669:Kidney Calculi / Q000737:chemistry*; D008875:Middle Aged; D053040:Nephrolithiasis / Q000139:chemically induced* / Q000628:therapy; D010554:Personality Disorders / Q000188:drug therapy; D019357:Potassium Citrate / Q000627:therapeutic use; D011619:Psychotropic Drugs / Q000009:adverse effects*; D000077236:Topiramate
D000700:Analgesics; D002130:Calcium Phosphates; D011619:Psychotropic Drugs; D000077236:Topiramate; D002129:Calcium Oxalate; D019343:Citric Acid; D005632:Fructose; C020243:calcium phosphate; D019357:Potassium Citrate