Case report

https://doi.org/10.11613/BM.2017.042

Topiramate induced metabolic acidosis and kidney stones – a case study

Tomas Salek orcid.org/0000-0002-8392-5003 ; Medical Faculty of the University of Ostrava in Ostrava, Ostrava – Zábřeh, Czech Republic
Ivan Andel ; Department of Urology, Tomas Bata Hospital in Zlin, Zlin, Czech Republic
Irena Kurfurstova ; Department of Clinical Biochemistry, Tomas Bata Hospital in Zlin, Zlin, Czech Republic

Abstract

IntroductionThe aim of this study is to present a case of 44 years old woman with topiramate induced metabolic acidosis and kidney stones. Materials and methodsThe laboratory features of topiramate caused renal tubular acidosis in blood and urine during topiramate treatment, with correction of metabolic acidosis by potassium citrate, and after topiramate withdrawal are presented. Differential diagnosis of all possible causes of metabolic acidosis is discussed. ResultsThe results revealed negative base excess in extracellular fluid of - 9.2 mmol/L, low serum HCO3- concentration (18.6 mmol/L), trend to alkaline urine (pH 6.39) and low urine citrate concentration (0.3 mmol/24h). After topiramate withdrawal, all parameters of the internal environment normalized. ConclusionsThis study has shown that long-term topiramate administration could induce metabolic acidosis and consequently urholithiasis. Thus, we could recommend testing blood acid base balance, urinary pH and citrates in patients taking topiramate and suffering from kidney stones.

Keywords

urolithiasis; acidosis; renal tubular acidosis; topiramate; glomerular filtration rate

Hrčak ID:

183391

URI

https://hrcak.srce.hr/183391

Publication date:

15.6.2017.

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