What are the side effects of topiramate on the kidney and what is the underlying pathomechanism?
Topiramate is an antiseizure drug that is also used to prevent migraine headaches.
Nephrolithiasis was noted at a higher-than-expected rate in patients treated with this medication, raising the possibility of a drug-related complication.
It was subsequently shown that topiramate acts as a carbonic anhydrase inhibitor and causes a defect in hydrogen secretion in both the proximal tubule and collecting duct.
This is a drug-induced type 1 and type 2 renal tubular acidosis (RTA).
These abnormalities produce an alkaline urine and promotes the formation of calcium phosphate stones.
