Research of nephrotoxicity in epileptic patients who are used valproic acid or carbamazepine

Epilepsy is a common neurologic disorder of children. One or multiple antiepileptic drugs (AED) are prescribed at least two years long, occasionally lifelong in treatment of epilepsy. Various side effects of AEDs may appear during treatment in many organ systems as well as other drugs. But recently nephrotoxicity of AEDs has been to come to order. Valproic acid (VPA) and carbamazepine (CBZ) is frequently to be administered in epilepsy treatment. In terms of nephrotoxicity of VPA and CBZ, various studies has been published. These investigations have been especially revealed about tubulotoxic effects.Glomerular filtration rate (GFR) measurement is a marker of glomerular damage. Gold standart method of GFR measurement is measured as the urinary or plasma clearance of an ideal filtration marker such as inulin or of alternative exogenous markers such as iothalamate, EDTA, DTPA and iohexol. Measurements with 24- hour CrCl and practical formulae based on serum Cr level are widely used for to determine GFR. But creatinin levels are to be influenced several factors. In recent years plasma Cystatin C (Cys C) has been proposed as a better marker of GFR than serum creatinine. And practical formulas based Cys C for GFR measurements have also been enhanced. In recent years several tubular enzymes and proteins have been investigated for determine tubular cell damage. NAG is a tubular cell lysosomal enzymes. If tubular damage is revealed NAG is delivered to urine more than normal amounts .In this study, the patients who are prescribed VPA (30 patients) and CBZ (24 patients) as diagnosed epilepsy (minimum three months, maximum two years ago) were included. Serum Cr, Cys C, spot urine NAG/Cr (UNAG/Cr) levels of patients who are in same clinical prognose were researched at initiation of study and after three months from beginning of study .Three GFR formulae with Cr, Cys C and combination of together were used for to determine GFR. Consequently, Serum Cr, Cys C and GFR values were stated normal range according to patient ages. However UNAG/Cr levels were stated more elevated than control group in both drug taking groups. Recognized realities regarding nephrotoxicity of VPA and CBZ are a few. Because VPA and CBZ are being metabolizes predominantly by liver. But tubulotoxic side effects of these drugs were verified with several studies and supported with this study. After this time clinicians must take into consideration these side effects probability and supervision for with essential kidney function tests intermittently for the patients who take high and/or multiple AEDs and has additional nephrotoxic risky