Pediatric Neurology Department, Neurosciences Center, Riyadh, Saudi Arabia.
Epilepsia. 2011 Oct;52(10):1890-3. doi: 10.1111/j.1528-1167.2011.03245.x. Epub 2011 Aug 29.
We ran this study to assess the incidence of nephrolithiasis in a group of children on topiramate (TPM) therapy for at least 1 year.
In this retrospective observational surveillance study, we reviewed the medical charts of children on TPM for at least 1 year seen at the pediatric neurology department during the period from 2005 to 2010 at King Fahad Medical City. Children with a normal baseline ultrasound report were included. Follow-up ultrasound reports after at least 1 year were collected. However, patients with any evidence of chronic illness or medications that may affect the kidney functions in addition to those who are not compliant with the prescribed dose were excluded. Family history of renal stones, symptoms suggestive of urologic disorders, and comorbidities were recorded.
Medical charts of 96 children on TPM with a mean age of 6.9 (±3.8) years were reviewed; 52 (54.2%) of the children were male. The follow-up ultrasound showed that five children (5.2%) had developed kidney stones. The occurrence of kidney stones was found in four female patients (80%) versus one male (20%) (p > 0.05).
Long-term use of TPM may result in increased incidence of asymptomatic kidney stones in the pediatric population. Hence, routine baseline and follow-up ultrasound of the urinary system should be recommended during the use of TPM in children.
我们开展这项研究,旨在评估至少接受托吡酯(TPM)治疗 1 年的儿童中肾结石的发病率。
在这项回顾性观察性监测研究中,我们回顾了 2005 年至 2010 年在法赫德国王医疗城儿科神经科接受 TPM 治疗至少 1 年的儿童的病历。纳入基线超声报告正常的儿童。收集至少 1 年后的随访超声报告。但排除了存在任何慢性疾病证据或可能影响肾功能的药物的患者,以及不遵守规定剂量的患者。记录了肾结石家族史、提示泌尿系统疾病的症状和合并症。
共回顾了 96 名接受 TPM 治疗的儿童的病历,平均年龄为 6.9(±3.8)岁;52 名(54.2%)儿童为男性。随访超声显示 5 名儿童(5.2%)出现肾结石。发现肾结石的发生在 4 名女性患者(80%)中,而在 1 名男性患者(20%)中(p>0.05)。
长期使用 TPM 可能导致儿科人群无症状肾结石的发病率增加。因此,在儿童中使用 TPM 时,应推荐常规进行基线和随访泌尿系统超声检查。