Pancreatitis in children on chronic dialysis treated with valproic acid.

Four children treated with maintenance dialysis, three peritoneal and one hemodialysis, developed pancreatitis while receiving valproic acid (VPA) for chronic seizure disorders. Two patients recovered, eventually resuming VPA therapy after successful cadaveric renal transplantation. Two children died after complications of pancreatitis. No episodes of pancreatitis occurred in the other 74 children in this maintenance dialysis population; none of whom received VPA. Although pancreatitis is a known complication of VPA treatment or end-stage renal disease (ESRD), this is the first reported series specifically relating pancreatitis to VPA administration in children treated with maintenance dialysis. The literature related to the association of pancreatitis with VPA administration and ESRD therapy is briefly reviewed and the clinical implications are discussed.