BACKGROUND and OBJECTIVES:
KD is a well-established treatment for drug-resistant childhood epilepsy with expanding indications in the neurometabolic field. MAD is one of the modalities of choice in intractable seizures in pediatrics being less restrictive. Renal calculi have been reported in patients on the KD and the current study was designed to evaluate the risk factors for their development in patients on MAD.
SETTING:
Pediatric Neurology Outpatient Clinic and Pediatric Clinical Nutrition Unit, Children's Hospital Ain Shams University.
PATIENTS AND METHODS:
Twenty patients with intractable epilepsy on MAD diet were subjected to full history taking, anthropometric measurements and laboratory investigations including complete urine analysis, urinary calcium after overnight fasting, calcium /creatinine ratio as well as pelvi-abdominal ultrasound basally, at 3 and 6 months from starting therapy. Frequency and severity of seizures assessed by Chalfont severity score were recorded
RESULTS:
The study revealed significant reductions in both frequency and severity of seizures with acceptable progress in their anthropometric measurements. Two patients (10%) developed renal stones after 6 months on MAD. Gross hematuria was reported in one of the two patient of renal stones while microscopic hematuria was detected in both. The urine calcium after overnight fasting and the urine calcium/ creatinine ratio were elevated in stone forming patients after 6 months and both tests were normal in patients without renal stones.
Conclusion:
MAD may increase the risk of incidence of renal stones, as a consequence of hypercalcuria which was clearly and significantly observed in the studied cases who developed renal stones.

MODIFIED ATKINS DIET FOR INTRACTABLE SEIZURES AND RISK OF UROLITHIASIS