STUDY CHARACTERISTICS
The characteristics of our included studies are summarised inTable 1 . In most cases, patients were commenced on CRRT for
acute kidney injury or known end-stage renal disease with multi-organ
failure. 16 out of 24 patients were treated with CVVHF with 8 other
patients treated with CVVHDF. Two patients [25,34] were
receiving simultaneous extracorporeal membrane oxygenation (ECMO). In
most patients (17 out of 24) a 1,000mg twelve-hourly dose of
levetiracetam was administered as intravenous bolus infusions. One
patient received enteral levetiracetam.
Sampling strategies across studies varied significantly. Pre-filter,
post-filter and effluent samples were collected in four studies while in
three studies only plasma samples (either peak or trough levels) were
taken. In most studies, levetiracetam levels were not taken until steady
state had been achieved. One compartmental modelling for pharmacokinetic
analysis was used in three studies [25, 34, 35] , while
Kalaria et. al used a non-compartmental approach.
The recommended delivered dose in CRRT varies but is considered to be
between 20 – 35 ml/kg/hr. The median delivered dose in these studies
ranged from 26.7 – 37.1 ml/kg/hr with significant variation seen in
Chappell et al. and Kalaria et al. Blood flow rates ranged from 180 –
250 ml/min and were broadly consistent across studies. The majority of
patients were either anuric or oliguric (defined as urine output
<400ml in 24 hours) but it should be noted that these data
were not collected by Chappell et al.