Renal Disorders

The neurologist usually is asked to consult on patients with renal disease and seizures for two reasons:1,2

1. Seizures associated with renal insufficiency, hemodialysis, or both
   • Seizures are associated with four conditions occurring with renal insufficiency:3
     • Uremic encephalopathy
     • Dialysis disequilibrium syndrome
     • Aluminum encephalopathy syndrome
     • Dialysis encephalopathy syndrome (dialysis dementia)
2. Management of antiepileptic drug therapy in patients with renal disease
   • The complex issues encountered in this situation require expertise in two areas:
     • Effects of renal insufficiency upon drug pharmacokinetics
     • Effects of hemodialysis upon drug pharmacokinetics
     • Effects of renal insufficiency and hemodialysis upon the pharmacokinetics of specific antiepileptic drugs

Adapted from: Browne TR. Renal disorders. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002;49-62. 
With permission from Elsevier (www.elsevier.com).