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World J Nephrol. Jun 30, 2020; 9(1): 1-8
Published online Jun 30, 2020. doi: 10.5527/wjn.v9.i1.1
Renal transplant recipient seizure practical management
Harpreet Sawhney, Simon S Gill
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
Processing time: 208 Days and 10.4 Hours
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.

Keywords: Seizures; Renal transplant; Haemodialysis; Uraemia; Antiepileptic drugs

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.