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Advanced Neurology Seizures and CKD

Furthering research
initiatives to determine Increasing
current uncertainties multi-disciplinary education
surrounding the for better awareness of
pathophysiology of elevated seizure risks in
CKD-associated seizures CKD

Future Research Considerations
in the topic of seizures and CKD

Establishing a greater Consideration of practical
international consensus on toolkits and algorithmic
indication, dosing, guidelines to assist clinical
supplementation and management of seizures for
monitoring of AEDs for patients with renal
CKD patients impairment in the acute
setting
Figure 3. Future research considerations in the topic of seizures and CKD.
AED: Antiepileptic drug; CKD: Chronic kidney disease.

mechanisms and etiologies of CKD-associated seizures. Resources: Henry H.L. Wu, Claire, C.Y. Wang, Suresh K.
Based on the understanding of these processes, we have Chhetri, Paul Warwicker
provided an overview of non-AED treatment strategies Supervision: Paul Warwicker
to reverse potential precipitating factors. The profiles of Writing – original draft: Henry H.L. Wu, Claire C.Y. Wang
available AEDs, with a special emphasis on their use in Writing – review & editing: Suresh K. Chhetri, Arvind
CKD, have also been discussed. Ponnusamy, Paul Warwicker
This review article provides a valuable guide for clinicians Ethics approval and consent to participate
faced with managing seizures in CKD patients. However, we
caution that this article is not written to provide definitive Not applicable.
advice and guidance for all scenarios of CKD-associated
seizures. Management should remain personalized, Consent for publication
reflecting the specific needs and goals of care of each Not applicable.
individual patient. There remain gaps in the knowledge base
relating to pathophysiology and management, particularly Availability of data
in determining an optimized AED prescription strategy Not applicable.
(Figure 3). This requires further collaborative research to
address current uncertainties and improve clinical outcomes. References

Acknowledgments 1. Fisher RS, Acevedo C, Arzimanoglou A, et al., 2014, ILAE
official report: A practical clinical definition of epilepsy.
None. Epilepsia, 55: 475–482.

Funding https://doi.org/10.1111/epi.12550
None. 2. Ben-Ari Y, Dudek FE, 2010, Primary and secondary
mechanisms of epileptogenesis in the temporal lobe: There
Conflict of interest is a before and an after. Epilepsy Curr, 10: 118–125.

The authors declare no conflicts of interest. https://doi.org/10.1111/j.1535–7511.2010.01376.x
3. McNamara JO, 1994, Cellular and molecular basis of
Author contributions epilepsy. J Neurosci, 14: 3413–3425.

Conceptualization: Henry H.L. Wu, Arvind Ponnusamy, 4. Vezzani A, Fujinami RS, White HS, et al., 2016, Infections,
Paul Warwicker inflammation and epilepsy. Acta Neuropathol, 131: 211–234.

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