Acetazolamide-induced nephrolithiasis: implications for neuromuscular disorders. Neurology 43:1105-1106

Neuromuscular Disease Center, University of Rochester School of Medicine and Dentistry, NY 14642.
Neurology (Impact Factor: 8.29). 07/1993; 43(6):1105-6. DOI: 10.1212/WNL.43.6.1105
Source: PubMed


Carbonic anhydrase inhibitors can cause nephrolithiasis. We studied 20 patients receiving long-term carbonic anhydrase inhibitor treatment for periodic paralysis and myotonia. Three patients on acetazolamide (15%) developed renal calculi. Extracorporeal lithotripsy successfully removed a renal calculus in one patient and surgery removed a staghorn calculus in another, permitting continued treatment. Renal function remained normal in all patients. Nephrolithiasis is a complication of acetazolamide but does not preclude its use.

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    • "The renal compensation for metabolic acidosis generates hypocitraturia which further augments the risk of crystalluria (Lamb et al., 2004; Go, 2005; Welch et al., 2006). TPM and ZNS monotherapy have been associated with rates of urolithiasis ranging from 1.5 to 3.7% (Leppik et al., 1993; Shorvon, 1996; Leppik, 1999; Wroe, 2007), whereas the stronger CA-I activity of AZM may account for its substantially higher rate of associated stone disease (reported as high as 15% (Tawil et al., 1993)). "
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    • "Others complain of paresthesias and cognitive impairment (described by patients as mental dullness, fogginess, inability to concentrate, or confusion) from acetazolamide. Acetazolamide-induced nephrolithiasis (calcium phosphate stones) is not uncommon [7,8] and can often be controlled with dose reduction and appropriate hydration under consultation with a urologist. "
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