ArticleBritish journal of clinical pharmacology2009
Effect of topiramate on acid-base balance: extent, mechanism and effects.
Article in British journal of clinical pharmacology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03354507 (Use of Sodium Bicarbonate to Alkalinize Serum/Urine in Pediatric Patients Treated With Topiramate), which is not on this map. Cited by 38 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Use of Sodium Bicarbonate to Alkalinize Serum/Urine in Pediatric Patients Treated With Topiramate (Pilot Study)
Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 123 citations in OpenAlex.
- Pooled it
- Metabolic disturbances and renal stone promotion on treatment with topiramate: a systematic review.British journal of clinical pharmacology · 2014Pooled it
- The effect of everolimus on renal angiomyolipoma in pediatric patients with tuberous sclerosis being treated for subependymal giant cell astrocytoma.Pediatric nephrology (Berlin, Germany) · 2018Trial
- When our treatment is complicated: an overview of drug-induced acid-base disorders: part 1-acidosis.Pediatric nephrology (Berlin, Germany) · 2026Review
- Topiramate for the treatment of neonatal seizures and beyond.Epilepsia · 2025Review
- Lifestyle Medicine for Obesity in the Era of Highly Effective Anti-Obesity Treatment.Nutrients · 2025Review
- Unraveling the nutritional challenges in epilepsy: Risks, deficiencies, and management strategies: A systematic review.World journal of experimental medicine · 2025Article
- The Neurocircuitry of Substance Use Disorder, Treatment, and Change: A Resource for Clinical Psychiatrists.The American journal of psychiatry · 2024Review
- Inherited Fanconi syndrome.World journal of pediatrics : WJP · 2023Review
- Tuberous Sclerosis Complex with Renal Stones and Distal Renal Tubular Acidosis: Case Report and Literature Review.Oman medical journal · 2023Article
- The pathophysiology of distal renal tubular acidosis.Nature reviews. Nephrology · 2023Review
- Topiramate alters the gut microbiome to aid in its anti-seizure effect.Frontiers in microbiology · 2023Article
- Topiramate-induced severe electrolyte abnormalities and hypernatremia leading to central pontine myelinolysis.BMJ case reports · 2021Article
- 19-year-old Woman with Intermittent Weakness.Clinical practice and cases in emergency medicine · 2021Article
- Topiramate causing type II renal tubular acidosis: A case and review of the mechanism.Clinical case reports · 2020Article
- Drug-Induced Urolithiasis in Pediatric Patients.Paediatric drugs · 2019Review
- Proximal renal tubular acidosis with and without Fanconi syndrome.Kidney research and clinical practice · 2019Review
- Oxalate transport by the mouse intestine in vitro is not affected by chronic challenges to systemic acid-base homeostasis.Urolithiasis · 2019Article
- Severe anion gap metabolic acidosis associated with initiation of a very low-carbohydrate diet.Journal of community hospital internal medicine perspectives · 2019Article
- Nephrolithiasis and Nephrocalcinosis From Topiramate Therapy in Children With Epilepsy.Kidney international reports · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Topiramate is licensed for the treatment of epilepsy and for migraine prophylaxis, but is also used off-licence for a wide range of indications. With the increasing use of topiramate, reports have emerged that topiramate can cause metabolic acidosis in some patients. It does this by impairing both the normal reabsorption of filtered HCO(3)(-) by the proximal renal tubule and the excretion of H(+) by the distal renal tubule. This combination of defects is termed mixed renal tubular acidosis (RTA). The mechanism involves the inhibition of the enzyme carbonic anhydrase, which is consistent with the fact that genetic deficiency of carbonic anhydrase is associated with mixed RTA. Topiramate-induced RTA can make patients acutely ill, and chronically, can lead to nephrolithiasis, osteoporosis and, in children, growth retardation. There is no proven method for predicting or preventing the effect of topiramate on acid-base balance, but patients with a history of renal calculi or known RTA should not receive topiramate. The utility of regular monitoring of HCO(3)(-) levels has not been proven and is not routine practice currently. For patients with persistent RTA, topiramate should usually be discontinued as alternative agents are available.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.