AlShaqaq Ali, Al Sahlawi Muthana, Amir Abdulrazack, Ahmed Mahmoud, Alkhunaizi Ahmed
Department of Medicine, Johns Hopkins Aramco Healthcare Center, Dhahran, Saudi Arabia.
Department of Internal Medicine, College of Medicine, King Faisal University, Al-Hasa, Saudi Arabia.
Perit Dial Int. 2025 Jan 8:8968608241311717. doi: 10.1177/08968608241311717.
Baclofen is a gamma-aminobutyric acid agonist that is commonly and widely used for the treatment of muscle spasticity. Given its predominant kidney excretion, patients with reduced kidney function are at particular risk of drug accumulation and toxicity, with neurotoxicity in the form of drowsiness, encephalopathy, seizures, and coma being the most reported clinical features. In addition to the importance of early identification of baclofen toxicity and drug discontinuation, dialysis can effectively accelerate baclofen elimination given its small molecule weight, and the relatively low volume of distribution and weak protein binding. While several cases of baclofen-induced toxicity have been reported in hemodialysis patients, the literature on baclofen toxicity in individuals receiving peritoneal dialysis (PD) is limited. Here, we present a case of baclofen-induced encephalopathy in a PD patient following a single dose of baclofen. In this case, our patient was managed by continuous (24 h) automated PD, with complete recovery of neurological status within three days.
巴氯芬是一种γ-氨基丁酸激动剂，常用于治疗肌肉痉挛。鉴于其主要经肾脏排泄，肾功能减退的患者尤其有药物蓄积和中毒的风险，最常报道的临床特征是以嗜睡、脑病、癫痫发作和昏迷形式出现的神经毒性。除了早期识别巴氯芬毒性并停药的重要性外，鉴于其分子量小、分布容积相对较低且蛋白结合较弱，透析可有效加速巴氯芬的清除。虽然血液透析患者中已有几例巴氯芬诱导毒性的报道，但关于接受腹膜透析（PD）的个体中巴氯芬毒性的文献有限。在此，我们报告一例单次服用巴氯芬后发生巴氯芬诱导脑病的PD患者。在该病例中，我们的患者接受持续（24小时）自动腹膜透析治疗，三天内神经状态完全恢复。
