Study of some renal function tests in epileptic children on antiepileptic drug monotherapy

ABSTRACT

In the present study we tried to verify the renal function status in epileptic children at diagnosis and 4 months following AED monotherapy. This study was carried out on 45 children, 27 males and 18 females aged 5-16 years, suffering from different types of freshly diagnosed epilepsy. They were classified into 3 groups Group 1 Consisted of 15 patients treated by carbamazepine [CBZ] [Tegretol] monotherapy. Group II Consisted of 15 patients treated by sodium valproate [VPA] [Depakine] monotherapy. Group Ill Consisted of 15 patients treated by phenytoin [PHE] [Epanutin] monotherapy. In addition 20 healthy children of matched age and sex, products of nonepileptic families, with normal hepatic and renal function tests, served as a control group. All children included in this study were subjected to the following determination of fasting blood urea, estimation of fasting serum creatinine, estimation of creatinine clearance, determination of urinary albumin/24 hours, urinary N-acetyl-8-D-glucosaminidase [NAG]/24h and urinary alpha-1 microglobulin [alpha-1MG]/24h. Our results revealed the following Normal renal glomerular and tubular function tests in patients before therapy. Normal renal glomerular function tests [blood urea nitrogen serum creatinine, creatinine clearance, routine urine analysis and 24 hr urinary albumin] in all patients after AED therapy. Significant increase in urinary NAG was observed in all patient groups after therapy and this increase was highest in patients receiving valproate monotherapy. Significant increases in urinary alpha-1MG in patients receiving carbamazepine or phenytoin with no change following VPA therapy were recorded