Hello, I ve never read anywhere about acute renal failure caused by topamax! It can cause oliguria sometimes which means a lower urine volume, which under certain circumstances may aggravate renal function and lead to acute renal failure (for example: in dehydrated patients). Topamax increased the rate of renal stone formation, which may lead to obstruction of the urinary tract and cause renal failure. Obstruction causes severe pain, so you should know it if something like that happened in your case. Topamax may - rarely - cause hypokalemia. Hypokalemia can also be caused by polyuric renal failure. Renal failure may present with either oliguria (less urine) or polyuria (excessive urine) and sometimes oliguria is followed by polyuria. When too much water is excreted, potassium is lost as well. So if you re passing liters of urine every day then a low potassium level can be attributed to polyuria. So in conclusion, I don t believe Topamax caused renal failure to you because there are not any reports that I know about such a side-effect of this drug. Topamax may indeed cause hypokalemia, although this is a rare event. Taking topamax requires intact kidney function. Otherwise dose reductions are required. You should consult your doctor for alternatives or for dose adjustment depending on your GFR (Glomerular Filtration Rate). I hope I ve helped! If you d like further information, please contact me again and I ll be glad to help. Kind Regards!