PMID- 28702868
OWN - NLM
STAT- MEDLINE
DCOM- 20180716
LR  - 20181202
IS  - 1867-0687 (Electronic)
VI  - 13
IP  - 6
DP  - 2017 Dec
TI  - Safety and tolerability of the ketogenic diet used for the treatment of 
      refractory childhood epilepsy: a systematic review of published prospective 
      studies.
PG  - 528-536
LID - 10.1007/s12519-017-0053-2 [doi]
AB  - BACKGROUND: To review the available evidence from prospective studies on the 
      safety and tolerability of the ketogenic diet (KD) for the treatment of 
      refractory childhood epilepsy. METHODS: A comprehensive bibliographic search was 
      performed with the aim of retrieving prospective studies that monitored adverse 
      effects (AEs) in children after receiving the classic or medium-chain 
      triglyceride KD therapy for refractory epilepsy. RESULTS: A total of 45 studies 
      were retrieved, including 7 randomized controlled trials. More than 40 categories 
      of AEs were reported. The most common AEs included gastrointestinal disturbances 
      (40.6%), hyperlipidemia (12.8%), hyperuricemia (4.4%), lethargy (4.1%), 
      infectious diseases (3.8%) and hypoproteinemia (3.8%). Severe AEs, such as 
      respiratory failure and pancreatitis, occurred in no more than 0.5% of children. 
      Specifically, patients receiving KD therapy should be monitored for osteopenia, 
      urological stones, right ventricular diastolic dysfunction, and growth 
      disturbance. The total retention rates of the diet for 1 year and 2 years were 
      45.7% and 29.2%, respectively. Nearly half of the patients discontinued the diet 
      because of lack of efficacy. AEs were not the main reason for the KD 
      discontinuation. None of the 24 deaths reported after initiation of the diet was 
      attributed to the KD. CONCLUSIONS: KD is a relatively safe dietary therapy. 
      However, because the KD can cause various AEs, it should be implemented under 
      careful medical supervision. Continuous follow-up is needed to address the 
      long-term impact of the diet on the overall health of children.
FAU - Cai, Qian-Yun
AU  - Cai QY
AD  - Department of Pediatrics, West China Second University Hospital, Sichuan 
      University, Chengdu, China.
AD  - Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth 
      Defects of Ministry of Education, Sichuan University, Chengdu, China.
FAU - Zhou, Zhong-Jie
AU  - Zhou ZJ
AD  - Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, 
      China.
FAU - Luo, Rong
AU  - Luo R
AD  - Department of Pediatrics, West China Second University Hospital, Sichuan 
      University, Chengdu, China.
AD  - Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth 
      Defects of Ministry of Education, Sichuan University, Chengdu, China.
FAU - Gan, Jing
AU  - Gan J
AD  - Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth 
      Defects of Ministry of Education, Sichuan University, Chengdu, China.
FAU - Li, Shi-Ping
AU  - Li SP
AD  - Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth 
      Defects of Ministry of Education, Sichuan University, Chengdu, China.
FAU - Mu, De-Zhi
AU  - Mu DZ
AD  - Department of Pediatrics, West China Second University Hospital, Sichuan 
      University, Chengdu, China.
AD  - Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth 
      Defects of Ministry of Education, Sichuan University, Chengdu, China.
FAU - Wan, Chao-Min
AU  - Wan CM
AD  - Department of Pediatrics, West China Second University Hospital, Sichuan 
      University, Chengdu, China. wcm0220@sina.com.
AD  - Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth 
      Defects of Ministry of Education, Sichuan University, Chengdu, China. 
      wcm0220@sina.com.
AD  - Department of Pediatrics, West China Second University Hospital, Key Laboratory 
      of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry 
      of Education, Sichuan University, Chengdu, 610041, China. wcm0220@sina.com.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20170712
PL  - Switzerland
TA  - World J Pediatr
JT  - World journal of pediatrics : WJP
JID - 101278599
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - China
MH  - Diet, Ketogenic/*statistics & numerical data
MH  - Drug Resistant Epilepsy/*diagnosis/*diet therapy
MH  - Female
MH  - Humans
MH  - Infant
MH  - Male
MH  - Patient Safety/*statistics & numerical data
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Treatment Outcome
OTO - NOTNLM
OT  - adverse effects
OT  - ketogenic diet
OT  - prospective studies
OT  - refractory childhood epilepsy
OT  - tolerability
EDAT- 2017/07/14 06:00
MHDA- 2018/07/17 06:00
CRDT- 2017/07/14 06:00
PHST- 2016/08/05 00:00 [received]
PHST- 2017/03/03 00:00 [accepted]
PHST- 2017/07/14 06:00 [pubmed]
PHST- 2018/07/17 06:00 [medline]
PHST- 2017/07/14 06:00 [entrez]
AID - 10.1007/s12519-017-0053-2 [pii]
AID - 10.1007/s12519-017-0053-2 [doi]
PST - ppublish
SO  - World J Pediatr. 2017 Dec;13(6):528-536. doi: 10.1007/s12519-017-0053-2. Epub 
      2017 Jul 12.