The effects of valproic acid and levetiracetam treatments on kidney functions in children with epilepsy
Year: 2025
Type: article
Study design: Observational Study
Abstract: Objectives: Clinical and subclinical evidence of kidney dysfunction has been reported with the use of some anti-epileptic drugs (AEDs) in children. This study aimed to evaluate renal tubular and glomerular functions using novel biomarkers N-acetyl-β-d-glycosaminidase (NAG), Kidney Injury Molecule-1(KIM-1) and 24-hour measured creatinine clearance (mClcr) in patients taking valproic acid (VPA) and levetiracetam (LEV). Methods: Fifty-one epileptic patients were included in this prospective case-control study between January 2023 and January 2024 in The Ankara Training and Research Hospital. Exclusions were made for individuals on multiple AEDs, those with incomplete data, bedridden patients, concurrent conditions (hypertension, obesity), or those using steroids or other medications. Participants had been on either VPA or LEV for at least six months. Sixteen healthy age- and sex-matched children served as the control group. Blood samples and 24-hour urine NAG, KIM-1, and mClcr measurements were collected. Results: The VPA, LEV, and control group comprised 30, 21, and 16 patients, respectively. The VPA group had higher urinary pH (6.1±0.7) and mClcr levels (173.4±48.0) than LEV (5.6±0.5, 149.7±39.1) and control (5.6±0.6, 130.6±30.6) groups. No significant difference was observed in urinary pH and mClcr levels between the LEV and control groups (p>0.05). No statistically significant differences were observed among the VPA, LEV, and control groups regarding 24-hour urinary NAG, KIM-1, NAG/creatinine, and KIM-1/creatinine levels (p>0.05). There was no significant association between mClcr levels and duration of treatment or serum drug levels on Spearman’s correlation coefficient (p>0.05). Conclusion: We found VPA-associated glomerular hyperfiltration in children with epilepsy. We did not observe tubular dysfunction in patients on VPA or LEV. doi: https://doi.org/10.12669/pjms.41.4.10385 How to cite this: Tas N, Balci O, Senes M, Bicakci S, Yılmaz A. The effects of valproic acid and levetiracetam treatments on kidney functions in children with epilepsy. Pak J Med Sci. 2025;41(4):997-1002. doi: https://doi.org/10.12669/pjms.41.4.10385 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Authors: Nesrin Tas, Ozge Balcı, Mehmet Senes, Sukran Bicakci, Arzu Yılmaz
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $400
OpenAlex ID: W4408902374