{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T15:24:44Z","timestamp":1778081084584,"version":"3.51.4"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2014,4,16]],"date-time":"2014-04-16T00:00:00Z","timestamp":1397606400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nephrol"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Levetiracetam is a frequently used drug in the therapy of partial onset, myoclonic and generalized tonic-clonic seizures. The main route of elimination is via the kidneys, which eliminate 66% of the unchanged drug as well as 24% as inactive metabolite that stems from enzymatic hydrolysis. Therefore dose adjustments are needed in patients with chronic kidney disease stage 5 D, i.e. patients undergoing dialysis treatment. In this patient population a dose reduction by 50% is recommended, so that patients receive 250\u2013750\u00a0mg every 12\u00a0hours. However \u201cdialysis\u201d can be performed in using different modalities and treatment intensities. For most of the drugs pharmacokinetic data and dosing recommendations for patients undergoing peritoneal dialysis are not available. This is the first report on levetiracetam pharmacokinetics in a peritoneal dialysis patient.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>A 73-y-old Caucasian male (height: 160\u00a0cm, weight 93\u00a0kg, BMI 36.3\u00a0kg\/m<jats:sup>2<\/jats:sup>) was admitted with a Glasgow Coma Scale of 10. Due to diabetic and hypertensive nephropathy he was undergoing peritoneal dialysis for two years. Eight weeks prior he was put on levetiracetam 500\u00a0mg twice daily for suspected partial seizures with secondary generalization. According to the patient\u2019s wife, levetiracetam lead to fatigue and somnolence leading to trauma with fracture of the metatarsal bone. Indeed, even 24\u00a0hours after discontinuation of levetiracetam blood level was still 29.8\u00a0mg\/l (therapeutic range: 12 \u2013 46\u00a0mg\/l). Fatigue and stupor had disappeared five days after discontinuation of the levetiracepam. A single dose pharamockinetic after re-exposure showed an increased half life of 18.4\u00a0hours (normal half life 7\u00a0hours) and levetiracetam content in the peritoneal dialysate. Both half-life and dialysate content might help to guide dosing in this patient population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>If levetiracetam is used in peritoneal dialysis patients it should be regularly monitored to avoid supratherapeutic levels that could lead to severe sequelae.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2369-15-49","type":"journal-article","created":{"date-parts":[[2014,4,16]],"date-time":"2014-04-16T11:04:49Z","timestamp":1397646289000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A missed opportunity \u2013 consequences of unknown levetiracepam pharmacokinetics in a peritoneal dialysis patient"],"prefix":"10.1186","volume":"15","author":[{"given":"Svenja K","family":"Bahte","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus","family":"Hiss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf","family":"Lichtinghagen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan T","family":"Kielstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2014,4,16]]},"reference":[{"key":"758_CR1","doi-asserted-by":"publisher","first-page":"S28","DOI":"10.1212\/WNL.67.12_suppl_4.S28","volume":"67","author":"G Lacerda","year":"2006","unstructured":"Lacerda G, Krummel T, Sabourdy C, Ryvlin P, Hirsch E: Optimizing therapy of seizures in patients with renal or hepatic dysfunction. 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