Abstract
To evaluate renal side-effects of anti-epileptic medication by valproate (VPA) and carbamazepine (CBZ), we performed a prospective study to assess renal tubular function by measuring N-acetyl-β glucosaminidase (NAG)/Cr activity index in epileptic children. The study was conducted on 112 children who were diagnosed with epilepsy (28 patients were observed before treatment with anti-epileptics, 28 children were administered VPA, 28 children were treated with CBZ, and 28 healthy children were selected age &sex matched for). An especial NAG assay kit was used for quantitative measuring of NAG in patient urine samples. The patients receiving VPA exhibited higher rate of NAG activity compared with the two groups which not receiving anti-epileptic drugs. Measurement of urinary NAG/Cr index in the children who received CBZ also, was significantly higher than those who were not administered anti-epileptic drugs. The measurement of NAG/Cr index in the VPA group was significantly higher than that in the CBZ group (NAG index: 2.75 versus 1.71). Children on anti-epileptic treatment with VPA or CBZ might demonstrate signs of renal tubular dysfunction, reflected by NAG/Cr activity index. This side effect can be potentially more occurred following VPA administration.
Highlights
The use of common antiepileptic drugs can potentially result in some toxic reactions such as dermatitis, nephritis, hepatitis, as well as severe anemia
Some of these impairments are characterized by the changes of enzymes that one of the most applicable enzymes secreted in urine is N-acetyl-b glucosaminidase (NAG) that its activity is considered as a sensitive marker for diagnosis of renal tubular impairment in various disease states and its clinical diagnostic efficiency has been approved in some researches [1,2]
The aim of this study was to assess the effect of some antiepileptic drugs (VPA and CBZ) on NAG activity measured by NAG/Cr activity index in epileptic children
Summary
The use of common antiepileptic drugs can potentially result in some toxic reactions such as dermatitis, nephritis, hepatitis, as well as severe anemia. Some of these impairments are characterized by the changes of enzymes that one of the most applicable enzymes secreted in urine is N-acetyl-b glucosaminidase (NAG) that its activity is considered as a sensitive marker for diagnosis of renal tubular impairment in various disease states and its clinical diagnostic efficiency has been approved in some researches [1,2]. NAG is a hydrolytic enzyme with a molecular weight of 130,000 to 140,000 daltons. It has previously been reported that NAG activity in rat urine anti-epileptic treatment regimens and compared it with those who were not administered anti-epileptic drugs
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