Abstracts

Rationale: The American diet provides approximately 15% of daily calories from protein, while the Low Glycemic Index Treatment (LGIT) for epilepsy specifies approximately 30% of calories from protein. Since high protein diets can affect renal function, reflected by increased blood urea nitrogen (BUN) levels, we asked if BUN levels are significantly increased in patients using the LGIT as a treatment modality for their intractable epilpesy. Methods: A retrospective chart review was conducted of patients educated to initiate the LGIT at the Massachusetts General Hospital for Children between 2003 and 2008. The information obtained for this review focused on demographics and laboratory values including BUN, Creatinine CO2 and Urine Specific Gravity. Patients were excluded if they did not have follow up data or were on the treatment for less than one month. Results: 109 patients were educated for implementation of the LGIT as a treatment modality for their intractable epilepsy. Seven patients did not initiate the treatment after education, and 25 patients were on the diet less than one month at time of analysis or did not have follow up lab values and were therefore excluded. Patients ranged in age from 3 to 25 years with an average age of 11 years, with 36 females and 41 males. Normal BUN ranges for children were considered <= 18 mg/dl. Slightly elevated BUN levels were noted in 34/77 (44%) patients; these ranged from 19-31 mg/dl. As elevated levels may be secondary to volume depletion, urine specific gravity was also assessed. The majority of these patients, 27/34 had concentrated urines with specific gravity of greater than 1.015. Metabolic acidosis can also raise BUN levels; five of the 34 patients had below normal CO2 levels (<21 mmol/L). In individual patients BUN levels did not always remain consistently elevated over time. All patients had creatinine levels within normal limits.