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Nephrolithiasis in topiramate users

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Abstract

Topiramate is a neuromodulatory agent increasingly prescribed for a number of neurological and non-neurological indications. Topiramate-treated patients are at risk for nephrolithiasis due to hypocitraturia and high urine pH. However, the prevalence of symptomatic stone disease in TPM users is generally perceived to be low. This study was undertaken to assess in topiramate-treated patients the prevalence of symptomatic nephrolithiasis (by history) and of asymptomatic nephrolithiasis by computed tomography (CT) scan. Topiramate users were identified from a database of patients with neurological disorders at a single university hospital. Among 75 topiramate-treated adult patients with a median daily dose of 300 mg and median treatment duration of 48 months, the prevalence of symptomatic nephrolithiasis was 10.7%. In a subset of topiramate-treated patients and no history of symptomatic stone disease, the prevalence of asymptomatic nephrolithiasis detected by CT scan was 20%. The prevalence of symptomatic nephrolithiasis with long-term topiramate use is higher than reported in short-term studies. Furthermore, clinical prevalence is underestimated due to asymptomatic nephrolithiasis.

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Acknowledgments

The authors were supported by the National Institutes of Health grants P01-DK20543 and K23RR21710, and a Seed Grant from the Pak Center of Mineral Metabolism.

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Author notes

  1. Joshua P. Langston

    Present address: Division of Urologic Surgery, University of North Carolina Department of Surgery, Chappell Hill, NC, USA

Authors and Affiliations

  1. Department of Internal Medicine, Charles and Jane Pak Center for Mineral Metabolism & Clinical Research, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8885, USA

    Naim M. Maalouf, Joshua P. Langston, Orson W. Moe & Khashayar Sakhaee

  2. Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA

    Paul C. Van Ness

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  1. Naim M. Maalouf
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  2. Joshua P. Langston
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  5. Khashayar Sakhaee
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Correspondence to Naim M. Maalouf.

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Maalouf, N.M., Langston, J.P., Van Ness, P.C. et al. Nephrolithiasis in topiramate users. Urol Res 39, 303–307 (2011). https://doi.org/10.1007/s00240-010-0347-5

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  • DOI: https://doi.org/10.1007/s00240-010-0347-5

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