Nefrolitiasis y topiramato

Jiménez, R. Domingo; Fernández, Carlos Casas; Mira, A. Puche; Martínez, Héctor A Rodríguez; Rodríguez, N. Escudero; Costa, T. Rodríguez; Avellaneda, E. Cao

doi:10.33588/rn.4202.2005125

Cited by 6 publications

(9 citation statements)

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“…Furthermore, two longitudinal case report studies in TPM-treated children demonstrated the increased risk of kidney stone formation in this population [98] . One case was a 7-month-old baby with intractable seizures due to the diagnosis of Dravet Syndrome.…”

Section: Risk In Childrenmentioning

confidence: 98%

Increased propensity for calcium phosphate kidney stones with topiramate use

Vega¹,

Maalouf²,

Sakhaee³

2007

Expert Opinion on Drug Safety

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Topiramate (TPM) is a neuromodulatory agent that was initially approved as an antiepileptic drug and is increasingly used in the treatment of a number of neurological and metabolic disorders. Among its various pharmacological actions, TPM has been shown to inhibit the activity of specific carbonic anhydrase enzymes in the kidney. This action is associated with the development of metabolic acidosis, hypocitraturia, hypercalciuria and elevated urine pH, leading to an increased risk of kidney stone disease. Despite the cautionary note in the package insert of TPM, the extent of these complications has not been fully explored. Few prescribing physicians are aware of these complications, underscoring the need for improved surveillance. Because the drug is among the most frequently prescribed agents in the US, more controlled studies are required to determine the prevalence of kidney stone disease among TPM users, and the optimal approach to prevent and treat nephrolithiasis in these individuals.

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Section: Risk In Childrenmentioning

confidence: 98%

Increased propensity for calcium phosphate kidney stones with topiramate use

Vega¹,

Maalouf²,

Sakhaee³

2007

Expert Opinion on Drug Safety

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“…publications found with both search terms). A total of 72 of them were reviewed in detail, and 47 articles published between 1996 and 2013 were retained for the final analysis, following inclusion of reports found in references (41 in English , five in Spanish and one in German ). They had been reported from following countries: USA ( n = 17), Spain ( n = 5), Great Britain ( n = 4), France ( n = 3), Italy ( n = 3), Brazil ( n = 2), Switzerland ( n = 2), Turkey ( n = 2), Argentina ( n = 1), Australia ( n = 1), Belgium ( n = 1), China ( n = 1), Germany ( n = 1), Hong Kong ( n = 1), Mexico ( n = 1), The Netherlands ( n = 1) and Saudi Arabia ( n = 1).…”

Section: Resultsmentioning

confidence: 99%

“…In these subjects, circulating bicarbonate ranged from 12.0 to 20.0 mmol l −1 . In 14 case reports , acidosis was associated with a tendency towards hyperchloraemia (level ranging between 111 and 120 mmol l −1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Metabolic factors that promote renal stone formation consist of either solute excess or decreased levels of inhibitors of stone formation. Eleven reports , including a total of 84 patients (female:male ratio = 2.9) on medication with topiramate, addressed at least one promoter of stone formation, as shown in Table . Rather discrepant findings were noted with respect to a possible solute excess of calcium and oxalate.…”

Section: Resultsmentioning

confidence: 99%

“…Hypercalciuria 34 31 [20], [23], [24], [46], [47], [49], [54] Hyperoxaluria 15 56 [20], [23], [24], [45], [47], [49] Hyperuricosuria 1 52 [23], [24], [47], [49] Hypocitraturia 67 0 [20], [23], [24], [46], [47], [49], [53], [54] become clinically relevant is undoubtedly essential. Unfortunately, so far no study has addressed the effects of alkali therapy on acid-base and potassium status, urinary citrate excretion and especially the tendency to renal stone formation in patients treated with topiramate.…”

Section: Not Disclosed Referencesmentioning

confidence: 99%

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Metabolic disturbances and renal stone promotion on treatment with topiramate: a systematic review

Dell’Orto

Belotti

Goeggel-Simonetti

et al. 2014

Br J Clin Pharmacol

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AIMSThe use of topiramate, which is prescribed for the management of epilepsy, for migraine headache prophylaxis and as a weight-loss agent, has been associated with the development of metabolic acidosis, hypokalaemia and renal stone disease. We systematically reviewed all the literature. METHODSThe systematic review of the literature was realized using the principles underlying the UK Economic and Social Research Council guidance on the conduct of narrative synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. RESULTSFourty-seven reports published between 1996 and 2013 were retained for the final analysis. Five case-control studies and six longitudinal studies addressed the effect of topiramate on acid-base and potassium balance. A significant tendency towards mild-to-moderate hyperchloraemic metabolic acidosis (with bicarbonate ≤21.0 mmol l −1 in approximately every third case) and mild hypokalaemia (with potassium ≤3.5 mmol l −1 in 10% of the cases) was noted on treatment with topiramate, which was similar in children and adults. A single study observed that topiramate causes mild hyperuricaemia in male adults. A tendency towards hypocitraturia, a recognized promoter of renal stone formation, was noted in all patients on topiramate. CONCLUSIONSIncreasing evidence supports the use of topiramate. Topiramate is generally well tolerated, and serious adverse events are rare. Nonetheless, the present systematic review of the literature indicates that its use is linked with the development of acidosis, hypokalaemia, hyperuricaemia and hypocitraturia.

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