{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:25:13Z","timestamp":1762323913667},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,6,21]],"date-time":"2016-06-21T00:00:00Z","timestamp":1466467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although Fanconi syndrome is rare in patients with epilepsy treated with sodium valproate (VPA), the prevalence might be higher in children with severe motor and intellectual disabilities (SMID). VPA\u2010induced Fanconi syndrome usually has a favorable outcome, but the long\u2010term outcome of renal tubular dysfunction in SMID patients remains unknown. The aim of this study was therefore to investigate the long\u2010term outcome of renal proximal dysfunction in SMID children with Fanconi syndrome caused by VPA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The records of six children with SMID and Fanconi syndrome caused by VPA were retrospectively reviewed to assess long\u2010term proximal renal tubular function after discontinuation of VPA. All six patients had intractable epilepsy and required tube feeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Proximal tubular dysfunction improved in almost all patients after VPA discontinuation, although abnormal uric acid reabsorption persisted in three patients. Five patients had hypocarnitinemia. After carnitine supplementation, one of these three patients with decreased ability to reabsorb uric acid had a normal serum level and improved fractional excretion of uric acid.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Secondary carnitine deficiency may cause prolonged tubular dysfunction in some SMID patients with VPA\u2010induced Fanconi syndrome. Fanconi syndrome caused by VPA is a usually reversible dysfunction of the proximal tubules, but can be permanent. Although not effective for all patients, carnitine is recommended for patients with VPA\u2010induced Fanconi syndrome, especially children with SMID.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.12956","type":"journal-article","created":{"date-parts":[[2016,2,20]],"date-time":"2016-02-20T20:38:14Z","timestamp":1456000694000},"page":"1023-1026","source":"Crossref","is-referenced-by-count":12,"title":["Outcome of renal proximal tubular dysfunction with Fanconi syndrome caused by sodium valproate"],"prefix":"10.1111","volume":"58","author":[{"given":"Sawako","family":"Yamazaki","sequence":"first","affiliation":[{"name":"Department of Pediatrics Niigata City General Hospital  Niigata Japan"},{"name":"Department of Pediatrics Nagaoka Institute for Severely Handicapped Children  Nagaoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Niigata City General Hospital  Niigata 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