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Kidney Week

Abstract: TH-PO058

Levetiracetam and the Risk of AKI: A Population-Based Cohort Study

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Yau, Kevin, Western University, London, Ontario, Canada
  • McArthur, Eric, Institute for Clinical Evaluative Sciences, London, Ontario, Canada
  • Jandoc, Racquel, Institute for Clinical Evaluative Sciences, London, Ontario, Canada
  • Muanda, Flory Tsobo, Western University, London, Ontario, Canada
  • Parikh, Chirag R., Yale University and VAMC, New Haven, Connecticut, United States
  • Wald, Ron, St. Michael's Hospital, Toronto, Ontario, Canada
  • Garg, Amit X., Western University, London, Ontario, Canada
Background

Regulatory agencies warn about the risk of acute kidney injury (AKI) with levetiracetam use based on information contained in case reports. We conducted this population-based cohort study to determine whether new levetiracetam use versus non-use is associated with AKI.

Methods

We performed a population-based retrospective cohort study in Ontario, Canada. Adults who received a new outpatient prescription for levetiracetam from an outpatient pharmacy between January 1, 2004 and March 1, 2017 were matched to two non-users on stage of chronic kidney disease, 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 serum concentration of 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 3,980 levetiracetam users to 7,960 non-users (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 non-users [odds ratio, 1.24; 95% CI, 0.62-2.47]). Similarly, there was no significant association with AKI within 180 days (odds ratio, 0.70; 95% CI, 0.43-1.13). The change in the concentration of serum creatinine did not significantly differ between levetiracetam users and non-users.

Conclusion

In this population-based study it is reassuring that levetiracetam use was not associated with a higher risk of AKI.

Outcomes Assessed Using Database Codes
 Levetiracetam users (n=3,980)Non-users (n=7,960)OR (95% CI)P-Value
Acute kidney injury (30 days)13 (0.33%)21 (0.26%)1.24 (0.62-2.47)0.55
Acute kidney injury (180 days)23 (1.15%)65 (1.63%)0.70 (0.43-1.13)0.15
Rhabdomyolysis (180 days)10 (0.50%)14 (0.35%)1.43 (0.64-3.22)0.39
Acute dialysis (180 days)0 (0.00%)≤5 (≤0.06%)--
Acute interstitial nephritis (180 days)5 (≤0.12%)≤5 (≤0.06%)--

To comply with privacy regulations to minimize the chance of identifying a study patient, numbers of patients were suppressed in the case of 1 to 5 patients (reported as ≤5).

Funding

  • Private Foundation Support