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Original ArticlesAcute Kidney Injury and ICU Nephrology
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Population-Based Study of Risk of AKI with Levetiracetam

Kevin Yau, Jorge G. Burneo, Racquel Jandoc, Eric McArthur, Flory Tsobo Muanda, Chirag R. Parikh, Ron Wald, Matthew A. Weir and Amit X. Garg
CJASN January 2019, 14 (1) 17-26; DOI: https://doi.org/10.2215/CJN.07490618
Kevin Yau
Division of Nephrology, Department of Medicine, and Departments ofInstitute for Clinical Evaluative Sciences, Ontario, Canada;
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Jorge G. Burneo
Institute for Clinical Evaluative Sciences, Ontario, Canada;Clinical Neurological Sciences and
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Racquel Jandoc
Institute for Clinical Evaluative Sciences, Ontario, Canada;
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Eric McArthur
Institute for Clinical Evaluative Sciences, Ontario, Canada;
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Flory Tsobo Muanda
Institute for Clinical Evaluative Sciences, Ontario, Canada;
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Chirag R. Parikh
Department of Medicine, Yale University, New Haven, CT; and
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Ron Wald
Institute for Clinical Evaluative Sciences, Ontario, Canada;Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Matthew A. Weir
Division of Nephrology, Department of Medicine, and Departments ofInstitute for Clinical Evaluative Sciences, Ontario, Canada;Epidemiology and Biostatistics, Western University, London, Ontario, Canada;
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Amit X. Garg
Division of Nephrology, Department of Medicine, and Departments ofInstitute for Clinical Evaluative Sciences, Ontario, Canada;Epidemiology and Biostatistics, Western University, London, Ontario, Canada;
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Abstract

Background and objectives Regulatory agencies warn about the risk of AKI with levetiracetam use on the basis of information from case reports. We conducted this study to determine whether new levetiracetam use versus nonuse is associated with a higher risk of AKI.

Design, setting, participants, & measurements This was a population-based retrospective cohort study of adults with epilepsy in Ontario, Canada. Patients who received a new outpatient prescription for levetiracetam between January 1, 2004 and March 1, 2017 were matched to two nonusers on stage of CKD, recorded seizure in the prior 90 days, and logit of a propensity score for levetiracetam use. The primary outcome was a hospital encounter (emergency department visit or hospitalization) with AKI within 30 days of cohort entry. Secondary outcomes were AKI within 180 days and change in the concentration of serum creatinine. We assessed the primary outcome using health care diagnosis codes. We evaluated the change in the concentration of serum creatinine in a subpopulation with laboratory measurements.

Results We matched 3980 levetiracetam users to 7960 nonusers (mean age 55 years, 51% women). Levetiracetam use was not significantly associated with a higher risk of AKI within 30 days (13 [0.33%] events in levetiracetam users and 21 [0.26%] events in nonusers [odds ratio, 1.24; 95% confidence interval, 0.62 to 2.47]). Similarly, there was no significant association with AKI within 180 days (odds ratio, 0.70; 95% confidence interval, 0.43 to 1.13). The change in the concentration of serum creatinine did not significantly differ between levetiracetam users and nonusers.

Conclusions In this population-based study levetiracetam use was not associated with a higher risk of AKI.

Podcast This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2018_12_11_Yau_Podcast.mp3

  • evetiracetam
  • acute renal failure
  • drug nephrotoxicity
  • interstitial, nephritis
  • Retrospective Studies
  • Odds Ratio
  • Propensity Score
  • etiracetam
  • creatinine
  • Outpatients
  • Acute Kidney Injury
  • Renal, Insufficiency, Chronic
  • Piracetam
  • Seizures
  • Epilepsy
  • hospitalization
  • Emergency Service
  • Hospital
  • Received June 23, 2018.
  • Accepted October 8, 2018.
  • Copyright © 2019 by the American Society of Nephrology
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Clinical Journal of the American Society of Nephrology: 14 (1)
Clinical Journal of the American Society of Nephrology
Vol. 14, Issue 1
January 07, 2019
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Population-Based Study of Risk of AKI with Levetiracetam
Kevin Yau, Jorge G. Burneo, Racquel Jandoc, Eric McArthur, Flory Tsobo Muanda, Chirag R. Parikh, Ron Wald, Matthew A. Weir, Amit X. Garg
CJASN Jan 2019, 14 (1) 17-26; DOI: 10.2215/CJN.07490618

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Population-Based Study of Risk of AKI with Levetiracetam
Kevin Yau, Jorge G. Burneo, Racquel Jandoc, Eric McArthur, Flory Tsobo Muanda, Chirag R. Parikh, Ron Wald, Matthew A. Weir, Amit X. Garg
CJASN Jan 2019, 14 (1) 17-26; DOI: 10.2215/CJN.07490618
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Keywords

  • evetiracetam
  • acute renal failure
  • drug nephrotoxicity
  • interstitial, nephritis
  • retrospective studies
  • odds ratio
  • Propensity Score
  • etiracetam
  • creatinine
  • Outpatients
  • acute kidney injury
  • Renal, Insufficiency, Chronic
  • Piracetam
  • Seizures
  • Epilepsy
  • hospitalization
  • Emergency Service
  • Hospital

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