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Prevalence and spot urine risk factors for renal stones in children taking topiramate.
- Source :
-
Journal of pediatric urology [J Pediatr Urol] 2013 Dec; Vol. 9 (6 Pt A), pp. 884-9. Date of Electronic Publication: 2013 Feb 01. - Publication Year :
- 2013
-
Abstract
- Introduction: Topiramate (TPM), an anti-epileptic drug with >4 million users, increases renal stones in adults. We screened outpatient TPM-treated children without history of stones to estimate the prevalence of renal stones and to characterize urine stone-risk profiles.<br />Methods: Children taking TPM ≥1 month underwent an interview, renal ultrasound, and spot urine testing in this prospective study. Normal spot urine values were defined as: calcium/creatinine ratio ≤0.20 mg/mg (>12 months) or ≤0.60 mg/mg (≤12 months), citrate/creatinine ratio >0.50 mg/mg, and pH ≤ 6.7.<br />Results: Of 41 patients with average age of 9.2 years (range 0.5-18.7), mean TPM dose of 8.0 mg/kg/day (range 1.4-23.6), and mean treatment duration of 27 months (range 1-112), two (4.9%) had renal stones. The majority of children taking TPM had lithogenic abnormalities on spot urine testing, including 21 (51%) with hypercalciuria, 38 (93%) with hypocitraturia, and 28 (68%) with pH ≥ 6.7. Hypercalciuria and hypocitraturia were independent of TPM dose and duration; urine pH increased with dose. 24-h urine parameters improved in 1 stone-former once TPM was weaned.<br />Conclusions: Asymptomatic stones were found in 2/41 (4.8%) children taking TPM. Risk factors for stones were present in the spot urine of most children, including hypocitraturia (93%) and hypercalciuria (51%), independent of TPM dose and duration. High urine pH, found in 68%, correlated with TPM dose. Pediatric specialists should be aware of increased risks for stones, hypercalciuria, hypocitraturia, and alkaline urine in children taking TPM.<br /> (Published by Elsevier Ltd.)
- Subjects :
- Adolescent
Alkalies urine
Calcium urine
Child
Child, Preschool
Citric Acid urine
Creatinine urine
Epilepsy epidemiology
Female
Fructose adverse effects
Humans
Hypercalciuria chemically induced
Hypercalciuria epidemiology
Hypercalciuria urine
Infant
Kidney Calculi urine
Male
Prevalence
Prospective Studies
Risk Factors
Topiramate
Anticonvulsants adverse effects
Epilepsy drug therapy
Fructose analogs & derivatives
Kidney Calculi chemically induced
Kidney Calculi epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1873-4898
- Volume :
- 9
- Issue :
- 6 Pt A
- Database :
- MEDLINE
- Journal :
- Journal of pediatric urology
- Publication Type :
- Academic Journal
- Accession number :
- 23375465
- Full Text :
- https://doi.org/10.1016/j.jpurol.2012.12.005