771 Available online at www.medicinescince.org ORIGINAL RESEARCH Medicine Science 2016;5(3):771-5 Evaluation of renal tubular function in epileptic children treated with levetiracetam Ahmet Taner Elmas, Serdal Gungor, Mujgan Arslan, Yilmaz Tabel, Sabiha Gungor Raif, Fatma Ozyalin İnönü University Medical Faculty, Department of Pediatric Nephrology, Malatya, Turkey İnönü University Medical Faculty, Department of Biochemistry, Malatya, Turkey Received 05 February 2016; March 11 March 2016 Available online 22 March 2016 with doi: 10.5455/medscience.2016.05.8440 Abstract Our study aim was to measure the urinary N-acetyl-β-D-glucosaminidase/creatinine (NAG/UCr) index in epileptic children who received levetiracetam (LEV) treatment at least for 6 months, and compare it to healthy children. Thirty five children with epilepsy were enrolled in this prospective study. NAG was studied using the calorimetric method and NAG levels were expressed in units per liter (U/L) and NAG/UCre levels were determined in U/mmol creatinine. There were no statistically significant differences for the urine NAG and NAG/UCr index before and after LEV treatment in the epileptic group (p>0.05, for each). There were no significant correlations between the serum concentration of LEV and urinary NAG levels (r=0.258, p=0.135) and NAG/UCr levels (r=0.164, p=0.346) before treatment. Our study demonstrated that LEV treatment was safe and did not interfere in renal tubular function in epileptic children. Keywords: Children, epilepsy, levetiracetam, N-acetyl-β-D-glucosaminidase, renal tubular function Introduction Urinary N-acetyl-β-D-glucosaminidase (NAG), a hydrolytic enzyme, has two isoenzymes in humans. The NAG-A isoenzyme is present in the lysosomes of renal proximal tubular cells and its increased concentration in urine is considered as a marker of acute kidney injury [1- 4]. Because of insufficient seizure control or important side effects during antiepileptic drugs (AEDs), epilepsy treatment in children is a difficult task in clinical practise [5,6]. Levetiracetam (LEV) is used for the treatment of partial-onset, myoclonic and primary generalized tonic– clonic seizures in children with a minimal side effect profile, not only as an adjunctive therapy but also as single-agent therapy for epilepsy [7]. AEDs may lead to impairment in renal function after a long treatment period [8-12]. While some studies have disputed the urinary NAG as a marker of AEDs-induced renal functional impairment [13-16], some others disclosed that the increased excretion of tubular enzymes and proteins does not necessarily owe to the side-effects of the AEDs but is most likely due to a physiological change in renal function that is related to epilepsy itself [17]. Thus, it is not clear whether epilepsy itself or the AEDs cause kidney damage. To the best of our knowledge, there are only two case reports about NAG levels in epilepsy patients treated with LEV, however, there are no further studies in the literature [11,12]. Therefore, in our study it was planned to evaluate the effects of LEV treatment on renal function in epileptic children. For that purpose we aimed to measure NAG/urine creatinine (UCr) activity index in epileptic children who received LEV treatment at least for 6 months and compare it to healthy children. Material and Methods Study population Thirty five children with epilepsy, who were followed by the department of pediatric neurology, were enrolled in this prospective study. Eighteen patients were boys and 17 were girls. Their median age was 8.0 years (5.0–15.5 yr.). Thirty five healthy children were included as controls. Of them, 14 (40%) were boys and 21 (60%) were girls and their median age was 8.5 years (1.0–17.0). None of the healthy children were on any medication at the time of urine sampling. All patients were ambulatory and none had mental retardation or neurological abnormalities. Children with the signs of renal dysfunction or those taking nephrotoxic medication and those with a previous history of renal disease, diabetes mellitus, liver diseases, chronic, metabolic, systemic or norodegenerative diseases were excluded from the study. Before medical therapy was initiated, blood urea nitrogen (BUN) (mg/dl), serum creatinine (SCr) (mg/dl), serum uric acid (mg/dl), liver *Corresponding Author: Yilmaz Tabel, Department of Pediatric Nephrology, İnönü University Medical Faculty, Malatya, Turkey E-mail: yilmaztabel@yahoo.com Medicine Science International Medical Journal