Altunbaşak S, Yildizaş D, Anarat A, Burgut H R
Department of Pediatric Neurology, Cukurova University Medical Faculty, Balcali-Adana, Turkey.
Pediatr Nephrol. 2001 Mar;16(3):256-9. doi: 10.1007/s004670000535.
To investigate the effects of valproic acid (VPA) on renal tubular function, we examined 15 ambulatory children with epilepsy who received VPA for at least 6 months. None of the patients had mental retardation. Fourteen age- and sex-matched children were used as a control group. No statistically significant differences were found between patients and control subjects with respect to blood urea nitrogen (BUN), creatinine (Cr), uric acid, creatinine clearance (Ccr), tubular reabsorption of phosphorus (TRP), urinary Ca:creatinine ratio, urinary pH and mean urinary beta2-microglobulin concentrations (P>0.05). Protein and glucose in patient urine samples were negative. Urine microscopic examinations and amino acid chromatographies of patients were also normal. However, significant differences were found between patient and control groups with respect to mean urinary N-acetyl-beta-D-glucosamine:creatinine ratio (NAG:Cr) and mean urinary malondialdehyde:creatinine (MDA:Cr) ratio (P<0.05). In conclusion, ambulatory children with epilepsy taking VPA therapy may develop proximal renal tubular dysfunction. Although this finding is clini-cally insignificant, it should be kept in mind during VPA therapy.
为研究丙戊酸（VPA）对肾小管功能的影响，我们对15例接受VPA治疗至少6个月的门诊癫痫患儿进行了检查。所有患者均无智力发育迟缓。选取14例年龄和性别匹配的儿童作为对照组。患者与对照受试者在血尿素氮（BUN）、肌酐（Cr）、尿酸、肌酐清除率（Ccr）、肾小管磷重吸收（TRP）、尿钙：肌酐比值、尿pH值及平均尿β2-微球蛋白浓度方面未发现统计学显著差异（P>0.05）。患者尿样中的蛋白质和葡萄糖均为阴性。患者的尿显微镜检查和氨基酸色谱分析也均正常。然而，患者组与对照组在平均尿N-乙酰-β-D-氨基葡萄糖：肌酐比值（NAG:Cr）和平均尿丙二醛：肌酐（MDA:Cr）比值方面存在显著差异（P<0.05）。总之，接受VPA治疗的门诊癫痫患儿可能会出现近端肾小管功能障碍。尽管这一发现临床意义不大，但在VPA治疗期间应予以关注。
