title: Evaluation of renal tubular function in children taking anti-epileptic treatment.
abstract: OBJECTIVE
  To assess the effects of anti-epileptic drugs on renal tubular function.
  
  
  METHODS
  Urinary N-acetyl-beta-D-glucosaminidase activity was measured in 114 epileptic children (mean age 5.6 +/- 1.1 years) who were undergoing monotherapy with valproate (n = 46), carbamazepine (n = 34), lamotrigine (n = 13) and combined therapy with valproate+carbamazepine (n = 21).
  
  
  RESULTS
  The urinary N-acetyl-beta-D-glucosaminidase index of valproate (P < 0.01), carbamazepine (P < 0.05) and polytherapy group (P < 0.01) were significantly elevated when compared with that of the control group. No significant difference in N-acetyl-beta-D-glucosaminidase levels was found between the lamotrigine group and the control subjects. We found that the distribution of the N-acetyl-beta-D-glucosaminidase values of patients depended significantly on the length of therapy (P < 0.01). The level of urinary excretion of N-acetyl-beta-D-glucosaminidase was significantly higher in the patients who were taking long-term treatment (>10 years) with valproate, carbamazepine and combined therapy than those taking therapy shorter than 10 years (P < 0.01). The mean serum concentrations of valproate and carbamazepine were 68.7 +/- 17.44 microg/mL and 5.41 +/- 1.23 microg/mL, respectively. There was a significant correlation between the serum concentration of valproate and urinary N-acetyl-beta-D-glucosaminidase levels (r = 0.44, P < 0.01). There was also a significant correlation between the serum concentration of carbamazepine and N-acetyl-beta-D-glucosaminidase excretion (r = 0.52, P < 0.01).
  
  
  CONCLUSIONS
  The present study demonstrated that in patients treated with valproate and carbamazepine, an impairment of tubular function can be present, whereas lamotrigine does not cause any significant change.
authors.affiliation: Department of Pediatrics, Güdhane Military Medical Academy, Ankara, Turkey. bulentunay@yahoo.com
authors.forename: Bulent
authors.initials: B
authors.lastname: Unay
authors.forename: Ridvan
authors.initials: R
authors.lastname: Akin
authors.forename: S Umit
authors.initials: SU
authors.lastname: Sarici
authors.forename: Faysal
authors.initials: F
authors.lastname: Gok
authors.forename: Ismail
authors.initials: I
authors.lastname: Kurt
authors.forename: Erdal
authors.initials: E
authors.lastname: Gokcay
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D015415:Biomarkers / Q000652:urine; D001806:Blood Urea Nitrogen; D002220:Carbamazepine / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D004359:Drug Therapy, Combination; D004828:Epilepsies, Partial / Q000188:drug therapy; D004829:Epilepsy, Generalized / Q000188:drug therapy*; D006801:Humans; D007684:Kidney Tubules / Q000187:drug effects* / Q000502:physiology; D000077213:Lamotrigine; D014227:Triazines / Q000008:administration & dosage / Q000009:adverse effects; D014635:Valproic Acid / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood
chemical_list: D000927:Anticonvulsants; D015415:Biomarkers; D014227:Triazines; D002220:Carbamazepine; D014635:Valproic Acid; D003404:Creatinine; D000118:Acetylglucosaminidase; D000077213:Lamotrigine