Impact of chronic kidney disease stage on seizure frequency and severity in pediatric epilepsy patients
Xingjia Tang1, Yang Shen2, Chongfeng Chen3
1Department of Paediatrics, The First Affiliated Hospital of Jinan University, Guangzhou, CN, 510630, China.
Insights
In pediatric epilepsy patients, impaired kidney function, indicated by higher Blood Urea Nitrogen (BUN) and serum creatinine, correlates with increased seizure frequency and severity. Metabolic dysfunction, not just CKD stage, impacts seizure burden.
Area of Science:
- Pediatric Nephrology
- Pediatric Neurology
- Clinical Comorbidities
Background:
- Epilepsy and Chronic Kidney Disease (CKD) frequently co-occur in children.
- The relationship between CKD progression and seizure activity in pediatric populations requires further investigation.
Purpose of the Study:
- To examine how CKD stage and renal function markers influence seizure frequency and severity in children with epilepsy.
- To elucidate the impact of metabolic dysfunction versus CKD staging on seizure burden.
Main Methods:
- A cross-sectional study involving 250 pediatric patients (2-18 years) with confirmed CKD and epilepsy.
- Data collected included seizure frequency, seizure severity (NHS3), serum creatinine, BUN, and CKD stage.
- Statistical analyses utilized Pearson correlation, ANOVA, and t-tests to assess associations.
Main Results:
- Elevated BUN and serum creatinine showed significant positive correlations with both seizure frequency and severity.
- Seizure severity did not significantly vary across different CKD stages.
- Epilepsy etiology (metabolic/genetic vs. structural) and seizure type (generalized vs. focal) significantly impacted seizure severity.
Conclusions:
- Impaired renal function markers (BUN, creatinine) are strongly linked to increased seizure frequency and severity in pediatric epilepsy patients with CKD.
- Metabolic dysfunction appears to be a more critical determinant of seizure burden than the stage of CKD.
- Integrated nephrological and neurological care, with regular monitoring of kidney function, is recommended for improved patient outcomes.
Background:
Chronic Kidney Disease (CKD) and epilepsy are common comorbidities in children; their clinical interaction in terms of seizure frequency and severity has been poorly explored. This study investigates the influence of CKD stage and kidney function markers on seizure outcomes in pediatric epilepsy patients.
Methods:
A cross-sectional study was conducted among 250 children aged 2-18 years with biopsy-confirmed CKD and a documented diagnosis of epilepsy. Clinical data were extracted from medical records, including seizure frequency, seizure severity (measured using the National Hospital Seizure Severity Scale, NHS3), serum creatinine, Blood Urea Nitrogen (BUN), and CKD stage. Statistical analyses were performed using SPSS version 26, employing Pearson correlation, one-way ANOVA, and independent samples t-tests to evaluate associations between kidney function, epilepsy etiology, seizure subtype, and seizure outcomes.
Results:
Significant positive correlations were observed between BUN and both seizure frequency (r = 0.45, p < 0.01) and seizure severity (r = 0.36, p < 0.01). Serum creatinine was similarly correlated with seizure frequency (r = 0.50, p < 0.01) and seizure severity (r = 0.48, p < 0.01). While seizure severity did not differ significantly across CKD stages, ANOVA revealed a significant effect of epilepsy etiology on seizure severity (F(2,247) = 39.45, p < 0.001), with higher severity in metabolic and genetic etiologies compared to structural ones. Additionally, generalized seizures were associated with greater severity than focal seizures (p < 0.001).
Conclusion:
Although seizure severity remained relatively constant across CKD stages, impaired renal function-reflected by elevated BUN and serum creatinine-was strongly associated with increased seizure frequency and severity. These findings suggest that metabolic dysfunction plays a more prominent role than CKD stage in determining seizure burden. Regular monitoring of kidney function markers, consideration of epilepsy etiology, and individualized management strategies integrating nephrological and neurological care may improve outcomes for children with CKD and epilepsy.
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