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Abstract
We investigated potential renal functional impairment induced by chronic use of anti-epileptic
drugs (AEDs) in 79 epileptic children. They were divided into five groups: valproic
acid (VPA) monotherapy where the serum concentration (SC) of VPA was no less than
60 μg/ml (VPA [SC≥ 60]) (15 cases), VPA monotherapy where the SC VPA was less than
60 μg/ml (VPA [SC< 60]) (29 cases), phenobarbital monotherapy (PB) (7 cases), carbamazepine
monotherapy (CBZ) (16 cases), and polytherapy containing VPA (12 cases). Urinalysis
(proteinuria and hematuria) and serum creatinine were normal except for two cases
of proteinuria and two cases of hematuria. The level of urinary excretion of N-acetyl-β-glucosaminidase
(u-NAG) was high in 29% of all patients, and 47% of VPA (SC≥ 60), 38% of CBZ, 25%
of polytherapy, and 24% of VPA (SC< 60) groups. There was a significant positive correlation
between serum concentration of VPA and u-NAG/urinary creatinine (u-Cr). The level
of guanidinoacetic acid (u-GAA) excreted in the urine was normal except in one patient.
U-NAG/u-Cr may be a more sensitive marker than u-GAA/u-Cr for renal functional impairment
in AED therapy.
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Article Info
Publication History
Accepted:
June 26,
1994
Received:
December 7,
1993
Identification
Copyright
© 1994 Elsevier Science B.V. All rights reserved. Published by Elsevier Inc.
