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Increased urinary excretion of tubular enzymes and proteins in children with epilepsy

R Korinthenberg1, J Säger, L B Zimmerhackl

  • 1Department of Neuropaediatrics and Muscular Diseases, Paediatric University Hospital, Freiburg, Germany. rudokori@kkl200.ukl.uni-freiburg.de

European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society
|March 30, 2001
PubMed

Insights

Children with epilepsy show increased urinary excretion of tubular enzymes and proteins before treatment. This alteration is linked to epilepsy itself, not anti-epileptic drugs, suggesting a physiological cause.

Area of Science:

  • Pediatric Nephrology
  • Clinical Neurology

Background:

  • Anti-epileptic drug (AED) treatment in children is associated with increased urinary excretion of tubular enzymes and proteins.
  • This finding has been attributed to subclinical renal-tubular damage or enzyme induction by AEDs.

Purpose of the Study:

  • To investigate the cause of increased urinary tubular enzyme and protein excretion in children with epilepsy.
  • To differentiate between drug side-effects and epilepsy-related physiological changes.

Main Methods:

  • Cross-sectional study comparing 29 children with epilepsy to 27 controls.
  • Urinary excretion of N-acetyl-beta-glucosaminidase and alpha1-microglobulin measured at diagnosis and 3-4 months later.
  • Analysis of children treated with carbamazepine or valproate.

Main Results:

  • Children with epilepsy exhibited significantly increased urinary excretion of N-acetyl-beta-glucosaminidase and alpha1-microglobulin at diagnosis, prior to AED treatment.
  • No significant differences were observed based on seizure etiology or type.
  • No further increase in excretion was noted after 3-4 months of treatment with carbamazepine or valproate.

Conclusions:

  • The increased urinary excretion of tubular enzymes and proteins in children with epilepsy is likely a physiological alteration associated with the condition itself, rather than a side-effect of anti-epileptic drugs.
  • The underlying cause remains unknown, but the role of serotonin metabolism is considered.

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