Havali Cengiz, Gücüyener Kıvılcım, Buyan Necla, Yılmaz Ünsal, Gürkaş Esra, Gülbahar Özlem, Demir Ercan, Serdaroğlu Ayşe
Department of Pediatric Neurology, Gazi University Faculty of Medicine, Ankara, Turkey
Department of Pediatric Neurology, Gazi University Faculty of Medicine, Ankara, Turkey.
J Child Neurol. 2015 Mar;30(3):301-6. doi: 10.1177/0883073814538505. Epub 2014 Jun 22.
The aim of this study was to investigate the effects of valproate and carbamazepine, on renal glomerular and tubular functions. The patient group comprised 54 children with new-onset epilepsy treated with valproate (n = 30) and carbamazepine (n = 24). Twenty-six healthy children were in the control group. The serum creatinine and cystatin C levels and urinary excretion of N-acetyl-β-d-glucosaminidase (NAG) levels were measured and the glomerular filtration rate (GFR) was estimated. Serum creatinine and cystatin C concentrations were not different between patients and controls. The glomerular filtration rate of the patient groups were higher than those of the control group. Thus, both drugs probably lead to glomerular hyperfiltration and toxicity for glomerular functions. However, urinary N-acetyl-β-d-glucosaminidase/creatinine levels were significantly higher in patients receiving only valproate (6.1 ± 5). The difference between carbamazepine and control groups was not significant for urinary N-acetyl-β-d-glucosaminidase/creatinine levels. Our data suggest that valproate has adverse effects on renal tubular functions.
本研究的目的是调查丙戊酸盐和卡马西平对肾小球和肾小管功能的影响。患者组包括54例新诊断癫痫的儿童，其中30例接受丙戊酸盐治疗，24例接受卡马西平治疗。26名健康儿童作为对照组。测量血清肌酐和胱抑素C水平以及N-乙酰-β-D-氨基葡萄糖苷酶（NAG）的尿排泄水平，并估算肾小球滤过率（GFR）。患者和对照组之间的血清肌酐和胱抑素C浓度无差异。患者组的肾小球滤过率高于对照组。因此，两种药物可能都会导致肾小球高滤过以及对肾小球功能产生毒性。然而，仅接受丙戊酸盐治疗的患者尿N-乙酰-β-D-氨基葡萄糖苷酶/肌酐水平显著更高（6.1±5）。卡马西平组和对照组之间尿N-乙酰-β-D-氨基葡萄糖苷酶/肌酐水平差异不显著。我们的数据表明丙戊酸盐对肾小管功能有不良影响。
