Baclofen-induced neurotoxicity in a dialysis patient managed with continuous venovenous hemodialysis: A case report and literature review

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-07-01 DOI:10.4103/tjem.tjem_231_23

Nejah F. Ellouze, D. Hazra, Suad Al Abri

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Abstract

Despite documented cases of baclofen toxicity in individuals with kidney disease, the drug is widely prescribed for various medical conditions, primarily spasticity, hiccups, and multiple sclerosis. Baclofen, a gamma-aminobutyric acid derivative, relies on renal excretion, rendering those with impaired kidney function susceptible to toxicity – a concern often underestimated by health-care providers. Adverse reactions, including single or double doses, are well documented in addition to multi-dose toxicity. This report discusses a case of baclofen-induced neurotoxicity in an end-stage renal disease patient undergoing dialysis, highlighting the subsequent management with continuous venovenous hemodialysis. In addition, it provides a comprehensive review of existing literature on baclofen toxicity in cases of renal insufficiency. Strikingly, the literature lacks clear guidelines regarding baclofen safety, dose adjustments, or renal function thresholds for contraindication. This contribution aims to augment understanding of this critical issue, emphasizing the need for heightened awareness and careful consideration of baclofen use in patients with kidney disease.

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一名接受持续静脉血液透析治疗的透析患者因巴氯芬引起的神经中毒：病例报告和文献综述

尽管有肾病患者服用巴氯芬中毒的病例记录，但这种药物仍被广泛用于治疗各种疾病，主要是痉挛、打嗝和多发性硬化症。巴氯芬是一种γ-氨基丁酸衍生物，依赖于肾脏排泄，因此肾功能受损者很容易中毒，而医疗服务提供者往往低估了这一问题。除了多剂量毒性外，包括单剂量或双剂量在内的不良反应也屡见记载。本报告讨论了一例接受透析治疗的终末期肾病患者因巴氯芬诱发神经毒性的病例，并重点介绍了随后采用持续静脉血液透析治疗的方法。此外，报告还全面回顾了有关肾功能不全情况下巴氯芬毒性的现有文献。令人震惊的是，文献中缺乏有关巴氯芬安全性、剂量调整或肾功能禁忌阈值的明确指南。本文旨在加深人们对这一关键问题的理解，强调肾病患者在使用巴氯芬时需要提高警惕并慎重考虑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.