Ellouze Nejah F, Hazra Darpanarayan, Al Abri Suad
Department of Emergency Medicine, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman.
Turk J Emerg Med. 2024 Jul 1;24(3):176-179. doi: 10.4103/tjem.tjem_231_23. eCollection 2024 Jul-Sep.
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.
尽管有文献记载肾病患者使用巴氯芬会出现中毒情况，但该药物仍被广泛用于多种医疗状况，主要是痉挛、打嗝和多发性硬化症。巴氯芬作为一种γ-氨基丁酸衍生物，依赖肾脏排泄，这使得肾功能受损者易发生中毒——而这一问题常常被医疗保健提供者低估。除了多剂量毒性外，单剂量或双剂量的不良反应也有充分记录。本报告讨论了一例正在接受透析的终末期肾病患者因巴氯芬导致神经毒性的病例，重点介绍了随后采用持续静脉-静脉血液透析的治疗方法。此外，它还对肾功能不全病例中巴氯芬毒性的现有文献进行了全面综述。引人注目的是，文献中缺乏关于巴氯芬安全性、剂量调整或禁忌的肾功能阈值的明确指南。本论文旨在加深对这一关键问题的理解，强调需要提高认识，并在肾病患者中谨慎考虑使用巴氯芬。
