SHM Converge Scientific Abstract ePoster Gallery-Triamterene-Exclusive Renal Calculus: A Rare Complication of a Potassium-Sparing Diuretic

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This case report describes an 88-year-old woman who presented to the emergency department with four days of left flank pain, nausea, and vomiting. She had a history of hypertension and had been taking triamterene/hydrochlorothiazide for several years. Imaging showed a 4 mm obstructing distal left ureteral stone. After admission for pain control, hydration, and tamsulosin, she passed the stone. Analysis revealed the stone was composed of 100% triamterene.<br /><br />Triamterene is a potassium-sparing diuretic often combined with hydrochlorothiazide for hypertension or edema. It is partly excreted in urine and can cause crystalluria and granular casts, especially at higher doses. Although rare, triamterene has been associated with kidney stone formation. Most reported triamterene stones contain mixed components such as calcium oxalate, apatite, or uric acid, and patients often have a prior history of nephrolithiasis. A stone made entirely of triamterene is very uncommon.<br /><br />This case is notable because the patient had no known prior kidney stone history and the calculus was 100% triamterene, making it an unusual presentation. After the diagnosis, triamterene was discontinued and replaced with spironolactone.<br /><br />The report highlights that clinicians should be aware of triamterene’s rare but important adverse effects, including crystalluria and nephrolithiasis, when prescribing this medication.

Asset Subtitle

Sharath Kommu

Meta Tag

Author List Shalini Arepally, Sharath Kommu

Category Clinical Vignettes

Concept Triamterene

Concept Nephrolithiasis

Concept Potassium-sparing diuretic

Concept Urinary Crystal

Concept Drug-induced nephrolithiasis

Distinguished Non-Finalist

Presenter Organization Marshfield Clinic Health System

Presenting Author Sharath Kommu

Track Adult

Keywords

triamterene

nephrolithiasis

kidney stone

ureteral stone

crystalluria

hydrochlorothiazide

diuretic

flank pain

case report

spironolactone

Triamterene

Nephrolithiasis

Potassium-sparing diuretic

Urinary Crystal

Drug-induced nephrolithiasis