Population-Based Study of Risk of AKI with Levetiracetam

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

Use of sodium–glucose cotransporter-2 inhibitors and risk of acute kidney injury in older adults with diabetes: a population-based cohort study

“…21 We have used these data sources to study associations between other drugs and the risk of AKI. [22][23][24][25] In this study we followed reporting guidelines for observational pharmacoepidemiology studies (Appendix 1C). 26…”

Use of clinical classifications software to address ICD coding transition in large healthcare databases analyzed via high‐dimensional propensity scores

“…Our interpretations assume that the true association of levetiracetam on the incidence of ARF is null, or close to null, as previously reported. 18 This assumption is supported by the fact that, with higher levels of adjustment, the point estimates moved toward the null value. In this study, the hd-PS added value to the adjustments based only on predefined variables, as has been observed in other studies.…”

Levetiracetam Induced Hyperkalemia – A Rare Side Effect in Elderly with Pre-Existing Subclinical Renal Insufficiency Presenting with Bradyarrhythmia

“…A study was carried in which 3980 levetiracetam users were matched to 7960 nonusers and levetiracetam use was not significantly associated with a higher risk of AKI within 30 days Similarly, there was no significant association with AKI within 180 days. The change in the concentration of serum creatinine did not significantly differ between levetiracetam users and nonusers [12]. Now to the second part, hyperkalemia is one of the most life threatening metabolic condition that can lead to cardiac arrest and it is also a reversible peri-arrest condition [13,14].…”