The electrocardiogram taken at 72 hours showed no pathological findings, renal function became normal creatinine: While gabapentin levels were not measured, the rapid resolution of the delirium and recovery of renal function after only two sessions of low cut-off haemodialysis seem to indicate that gabapentin caused the symptoms. Over the next 24 hours, there were further improvements in her cognitive function, as well as a steady decline in her creatinine level. All doctors need to be aware of the need to review the indications for gabapentin use during periods of acute illness, especially with regard to renal impairment.
Fracaso renal agudo por gabapentina. Descripción de un caso y revisión de la literatura
Our case report highlights the need for diligent prescribing. Due to the patient history mentioned above, we screened urine for toxins, and it was positive for cocaine, heroin and morphine. Related Articles in Nefrologia. Is inappropriate medication use a major cause of adverse drug reactions in the elderly? These have included subtle changes in mental status, drowsiness, and even coma.
Gabapentin is known to be effective in the treatment of neuropathic pain . Am J Kidney Dis ;45 6: A method for estimatingthe probability of adverse drug reactions. Rhabdomyolysis with associated acute renal failure is an uncommon side effect, but it has been described in earlier cases.
The analgesic mechanism of action of gabapentin has yet to be fully elucidated. Her urine output was negligible. There was no history of renal impairment before this time. No positive microbiological cultures were reported.
Pharmacocinetics of gabapentin in subjects with various degrees of renal function. The provisional diagnosis was of musculoskeletal right hip pain with coexisting biliary infection. The aetiology of rhabdomyolysis varies greatly. Joint Bone Spine ; Thus, plasma levels will rise as renal clearance falls. It is entirely excreted through the renal system so this needs to be considered in any patient becoming acutely ill and developing renal failure.
Its most frequent causes include trauma, intense physical exercise, infections, and drugs such as statins, fibrates, neuroleptics, colchicine and proton pump inhibitors. Education for all doctors about the importance of gabapentin dosage adjustment in renal failure could prevent many similar events from occurring in the future.
Her conscious level improved with fluid and norepinephrine therapy. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-No Derivative Works License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited. Blood tests revealed anemia hemoglobin [Hb] 9.