Topiramate use was associated with a lower risk of ESKD, and the association was observed in men and women, independent of history of blood pressure, diabetes mellitus, treatments for kidney and cardiovascular disease (including renin-angiotensin system blockers, SGLT2i and GLP1-RA), HbA1c, lipids, eGFR levels, and albuminuria (although the number of patients with albuminuria results was small). This evidence concerns the gene REN and cardiovascular disorder.