Gerber L, Wüthrich R P, Mohebbi N
Klinik für Nephrologie, Universitätsspital Zürich, Switzerland.
Praxis (Bern 1994). 2012 May 9;101(10):665-8. doi: 10.1024/1661-8157/a000936.
A 42-year old woman was referred for a metabolic evaluation after two episodes of kidney stones. Her laboratory results revealed a normal anion-gap metabolic acidosis, a marked hypocitraturia (0,6 mmol/24h; norm 1,6-4,5) and a urinary pH of 7,0 confirming renal tubular acidosis (RTA). We identified topiramate, our patient's medication for migraine, as the cause of the RTA. Topiramate, a carboanhydrase inhibitor leads to RTA of a mixed (proximal and distal) type and thus significantly increases the risk for kidney stones.
一名42岁女性在经历两次肾结石发作后接受代谢评估。她的实验室检查结果显示为正常阴离子间隙代谢性酸中毒、显著低枸橼酸尿症(0.6毫摩尔/24小时;正常范围为1.6 - 4.5)以及尿pH值为7.0,证实为肾小管酸中毒(RTA)。我们确定患者用于治疗偏头痛的药物托吡酯是导致RTA的原因。托吡酯作为一种碳酸酐酶抑制剂,可导致混合型(近端和远端)RTA,从而显著增加肾结石风险。