Chappell K, Kimmons LA, Haller JT, et al. - The present study was conducted to ascertain the clearance of levetiracetam in patients requiring continuous renal replacement therapy (CRRT) or sustained low-efficiency dialysis (SLED). Researchers included adult individuals with acute kidney injury or end-stage renal disease needing either CRRT or SLED and levetiracetam for inclusion. They collected simultaneous arterial, venous, and effluent samples for analysis of levetiracetam concentrations every two hours for up to 6–8 h. They estimated levetiracetam clearance and half-life (t1/2) for each modality. This study was completed by eight CRRT patients and 4 SLED patients: 67% male, mean age 50 ± 13 years, and 83% had acute kidney injury. The findings revealed that levetiracetam clearance was substantial with both modalities under the operating conditions reported. The outcomes illustrated that there is the potential for subtherapeutic concentrations with currently recommended dosing strategies that account only for kidney function and not these extracorporeal routes of elimination.