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“TPM and zonisamide ZNS ) mainly increase the risk of calcium phosphate and not calcium oxalate, which is mentioned by Jion et al. Indeed, most clinicians are unaware of TPM-associated nephrolithiasis.”
“The supposed mechanism is that zonisamide induces urine alkalinization and then promotes crystallization of urine components such as calcium phosphate by inhibition of carbonate dehydratase in renal tubular epithelial cells.”