UrinaryN-acetyl-β-glucosaminidase and guanidinoacetic acid levels in epileptic patients treated with anti-epileptic drugs

Otsuka, Takayuki; Sunaga, Yasuo; Hikima, Akio

doi:10.1016/0387-7604(94)90003-5

Cited by 15 publications

(13 citation statements)

References 30 publications

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“…In a study by Otsuka et al the level of urinary excretion of NAG was high in 29% of all patients, in 47% of VPA group, and in 38% of CBZ group. In their study, a significant positive correlation was observed between NAG/Cr index and serum concentration of VPA [9]. In another study by Tseng et al VPA administration was accompanied with the highest incidence of abnormal urinary NAG/Cr index (in about 78% of treated children) that was significantly higher than that in the CBZ group with the incidence of 26%.…”

Section: Discussionmentioning

confidence: 98%

Renal tubular dysfunction measured by N-acetyl-beta glucosaminidase/Creatinine activity index in children receiving antiepileptic drugs: a randomized controlled trial

2011

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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.

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Section: Discussionmentioning

confidence: 98%

Renal tubular dysfunction measured by N-acetyl-beta glucosaminidase/Creatinine activity index in children receiving antiepileptic drugs: a randomized controlled trial

2011

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“…Some antiepileptic drugs (AEDs) may be associated with renal tubular impairment [1][2][3][4] . We reported two cases of severely disabled, developmentally delayed children in whom Fanconi syndrome developed after continuous valproic acid (VPA) administration 5) .…”

Section: Introductionmentioning

confidence: 99%

Side Effects of Antiepileptic Drugs on Renal Tubular Function in Childhood-onset Epilepsy

Endo

Fujita

Fuchigami

et al. 2012

Nichidai Igaku Zasshi

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Valproic acid-induced Fanconi syndrome in severely disabled, developmentally retarded, and non-ambulatory epileptic children has gradually become more widespread. Although the mechanism is unclear, renal involvement has been suspected. We investigated the effect of antiepileptic drugs and ambulatory state on renal tubular function in epileptic patients. We studied 77 patients who were treated at the Department of Pediatrics and Child Health, Nihon University Itabashi Hospital. The patients were divided into three groups according to antiepileptic drug administration and ambulatory state: severely disabled patients taking mainly valproic acid (9 cases), ambulatory patients taking valproic acid monotherapy (34 patients), and ambulatory patients taking carbamazepine monotherapy (34 patients). Laboratory analysis of renal tubular function showed that β 2-microglobulin levels were increased significantly in severely disabled patients. In addition, α 1-microgulobulin levels were increased significantly in ambulatory patients receiving carbamazepine monotherapy but not valproic acid. These results suggest that carbamazepine affects renal tubular function to a greater extent than valproic acid in ambulatory non-handicapped patients with epilepsy. We propose the importance of monitoring urinary α 1-microgulobulin and β 2-microglobulin levels in epileptic children for the early detection of subclinical renal tubular dysfunction.

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“…In a previous study [14], it was revealed that the NAG levels were high in 29% of all patients, in 47% of a valproate group, and in 38% of a carbamazepine group. The mentioned study also showed that a significant positive correlation was observed between NAG/UCr index and serum concentration of valproate.…”

Section: Discussionmentioning

confidence: 99%

“…AEDs may lead to impairment in renal function after a long treatment period [8][9][10][11][12]. While some studies have disputed the urinary NAG as a marker of AEDs-induced renal functional impairment [13][14][15][16], some others disclosed that the increased excretion of tubular enzymes and proteins does not necessarily owe to the side-effects of the AEDs but is most likely due to a physiological change in renal function that is related to epilepsy itself [17]. Thus, it is not clear whether epilepsy itself or the AEDs cause kidney damage.…”

Section: Urinarymentioning

confidence: 99%

Evaluation of renal tubular function in epileptic children treated with levetiracetam

Elmas¹,

Güngör²,

Arslan³

et al. 2016

Med-Science

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Our study aim was to measure the urinary N-acetyl-β-D-glucosaminidase/creatinine (NAG/UCr) index in epileptic children who received levetiracetam (LEV) treatment at least for 6 months, and compare it to healthy children. Thirty five children with epilepsy were enrolled in this prospective study. NAG was studied using the calorimetric method and NAG levels were expressed in units per liter (U/L) and NAG/UCre levels were determined in U/mmol creatinine. There were no statistically significant differences for the urine NAG and NAG/UCr index before and after LEV treatment in the epileptic group (p>0.05, for each). There were no significant correlations between the serum concentration of LEV and urinary NAG levels (r=0.258, p=0.135) and NAG/UCr levels (r=0.164, p=0.346) before treatment. Our study demonstrated that LEV treatment was safe and did not interfere in renal tubular function in epileptic children.

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UrinaryN-acetyl-β-glucosaminidase and guanidinoacetic acid levels in epileptic patients treated with anti-epileptic drugs

Cited by 15 publications

References 30 publications

Renal tubular dysfunction measured by N-acetyl-beta glucosaminidase/Creatinine activity index in children receiving antiepileptic drugs: a randomized controlled trial

Renal tubular dysfunction measured by N-acetyl-beta glucosaminidase/Creatinine activity index in children receiving antiepileptic drugs: a randomized controlled trial

Side Effects of Antiepileptic Drugs on Renal Tubular Function in Childhood-onset Epilepsy

Evaluation of renal tubular function in epileptic children treated with levetiracetam

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