Harpreet Sawhney, MA(Cantab) MBBS, MRCP, Doctor, Department of Nephrology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 0HS, United Kingdom. harpreet.sawhney@doctors.org.uk
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Harpreet Sawhney, Department of Nephrology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London W12 0HS, United Kingdom
Simon S Gill, Department of Radiology, Frimley Health NHS Foundation Trust, Slough, Berkshire SL2 4HL, United Kingdom
Author contributions: Sawhney H was involved in writing the original draft, read and approved the final manuscript; and Gill SS was involved in writing the original draft, read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Harpreet Sawhney, MA(Cantab) MBBS, MRCP, Doctor, Department of Nephrology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 0HS, United Kingdom. harpreet.sawhney@doctors.org.uk
Received: December 2, 2019 Peer-review started: December 2, 2019 First decision: December 11, 2019 Revised: May 23, 2020 Accepted: June 10, 2020 Article in press: June 10, 2020 Published online: June 30, 2020
Abstract
Seizures are not uncommon in renal transplant patients. The common aetiologies are metabolic disturbance associated with renal failure, immunosuppression and associated complications and infections. Their management can be challenging because of altered pharmacokinetics of antiepileptic drugs (AEDs) and their removal by dialysis. A practical approach to the management of seizure in renal transplant patients is discussed. This review highlights the guidelines for use of various AEDs in renal transplants.
Core tip: For selection of an antiepileptic drug (AED) in renal transplant patients: it should be a non-enzyme inducer; its metabolism and excretion should not be affected by renal failure; there are minimal dose adjustments with haemodialysis; the loading dose of most AED remain the same in renal impairment; and, sodium valproate is a good choice for an antiepileptic drug in renal transplant patients.
