Format

Send to

Choose Destination
Am J Kidney Dis. 2017 Dec;70(6):878-880. doi: 10.1053/j.ajkd.2017.05.010. Epub 2017 Jul 1.

Treatment of Gabapentin Toxicity With Peritoneal Dialysis: Assessment of Gabapentin Clearance.

Author information

1
Division of Nephrology, Department of Internal Medicine, Saint Louis University, St. Louis, MO.
2
Division of Nephrology, Department of Internal Medicine, Saint Louis University, St. Louis, MO. Electronic address: edwardjc@slu.edu.

Abstract

Gabapentin is almost exclusively cleared by the kidney and thus presents challenges in patients with kidney failure. Gabapentin is known to be effectively cleared by hemodialysis, but the efficiency of clearance by peritoneal dialysis (PD) has not been previously described. We report a case of gabapentin toxicity in a patient on long-term PD who was treated with continuous automated cycling PD. We find that continuous PD provides significant clearance of gabapentin. With 2-L exchanges every 2 hours, we document an apparent elimination half-life of 41.33 hours, which is substantially shorter than the reported elimination half-life of 132 hours in the absence of kidney function. Further, our patient's symptoms of gabapentin toxicity gradually improved and had fully resolved after about 36 hours of dialysis. Gabapentin clearance by PD was estimated at 94% of urea clearance. We conclude that intensive PD provides gabapentin clearance that approximates that of urea and is an effective but slow method to treat gabapentin overdose and toxicity.

KEYWORDS:

Gabapentin; case report; drug clearance; elimination half-life; end-stage renal disease (ESRD); gabapentin clearance; hemodialysis; myoclonus; peritoneal dialysis (PD); toxicity; urea clearance

PMID:
28676198
DOI:
10.1053/j.ajkd.2017.05.010
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center