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Pharmacological monitoring of antiepileptic drugs in epilepsy patients on haemodialysis Volume 22, issue 1, February 2020

Figure 1

Flow chart of the selection of the 36 epilepsy patients on haemodialysis enrolled in the study. CT: computed tomography; MRI: magnetic resonance imaging.

Figure 2

Antiepileptic drug use, clearance rate during dialysis, and pharmacokinetics in patients on haemodialysis (HD). (A) Number of patients using the indicated antiepileptic drugs (AEDs). (B) Clearance rate of AEDs during dialysis: LEV (nine patients, 34 samples), VPA (four patients, 23 samples), CBZ (two patients, 11 samples), PHT (four patients, 37 samples), CLB (two patients, 14 samples), and PB (one patient, seven samples). (mean ± SEM). (C-F) Dose and concentration data before (pre-) HD and after (post-) HD. (C) LEV (nine patients, 34 samples): pre-HD CD ratio = 3.15 ± 0.20; post-HD CD ratio = 1.12 ± 0.088. (D) VPA (four patients, 23 samples): pre-HD CD ratio = 4.81 ± 0.27; post-HD CD ratio = 3.30 ± 0.30. (E) PHT (four patients, 38 samples): pre-HD, CD ratio = 3.10 ± 0.12; post-HD CD ratio = 2.22 ± 0.11. (F) CBZ (two patients, 11 samples): pre-HD CD ratio = 2.14 ± 0.23; post-HD CD ratio = 1.28 ± 0.19. CD ratios are expressed as mean ± SEM, and the significance of differences was evaluated with one-sample t-tests for before-HD and after-HD values (*p < 0.001). The horizontal red bar indicates the reference range: LEV at 12-46 mcg/mL; VPA at 50-100 mcg/mL; PHT at 10-20 mcg/mL; and CBZ at 4-12 mcg/mL. LEV: levetiracetam; VPA: valproic acid; PHT: phenytoin; CBZ: carbamazepine.