title: Topiramate may not increase risk of urolithiasis: A nationwide population-based cohort study.
abstract: OBJECTIVE
  Topiramate is an effective anti-epileptic drug and can be associated with increased risk for urolithiasis because of its effects on acid-base profile. Evidences that supported an association of topiramate and urolithiasis were limited to case reports or series. We investigated the association of topiramate and urolithiasis in a nationwide population-based cohort study.
  
  
  METHODS
  We analyzed 1377 patients receiving topiramate and 1377 age- and gender-matched control patients (not receiving topiramate) between 1997 and 2008. The risk of urolithiasis was analyzed using Kaplan-Meier analysis, followed by Cox proportional hazard regression.
  
  
  RESULTS
  Of the 2754 patients, 79 (2.9%) patients developed urolithiasis in two (interquartile range: 1.2-4.2) years. The proportion of patients who developed urolithiasis in the patients receiving topiramate was not different from that of the control patients (p=0.138, χ(2) test). The urolithiasis free survival was not different between the patients receiving topiramate and the control patients (p=0.168) in Cox proportional hazard regression. The duration and total dosage of topiramate were not associated with risk of urolithiasis in patients receiving topiramate (p=0.482 and p=0.751).
  
  
  CONCLUSIONS
  Topiramate may not increase the risk of urolithiasis. The duration and the total dosage of topiramate were not associated with urolithiasis risks.
authors.affiliation: Department of Neurology, Sijhih Cathay General Hospital, New Taipei City, Taiwan.
authors.forename: Ai-Ling
authors.initials: AL
authors.lastname: Shen
authors.affiliation: Department of Neurology, Sijhih Cathay General Hospital, New Taipei City, Taiwan.
authors.forename: Hsiu-Li
authors.initials: HL
authors.lastname: Lin
authors.affiliation: Department of Neurology, Sijhih Cathay General Hospital, New Taipei City, Taiwan.
authors.forename: Yuan-Fu
authors.initials: YF
authors.lastname: Tseng
authors.affiliation: Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hsiu-Chen
authors.initials: HC
authors.lastname: Lin
authors.affiliation: Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chien-Yeh
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: Division of Nephrology and Kidney Institute, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan. Electronic address: cychou.chou@gmail.com.
authors.forename: Che-Yi
authors.initials: CY
authors.lastname: Chou
mesh_terms: D000328:Adult; D000367:Age Factors; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D015210:Arthritis, Gouty / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005632:Fructose / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D000077236:Topiramate; D052878:Urolithiasis / Q000139:chemically induced* / Q000453:epidemiology*
chemical_list: D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose
keywords: Health insurance database; Renal stone; Topiramate; Urolithiasis