Reversible acute renal allograft dysfunction due to gabapentin

Background. The use of gabapentin as an effective analgesic agent for neuro pathic pain has expanded considerably. Its lack of both anticholinergic sid e effects and interference with the metabolism of drugs via the cytochrome P450 pathway make it especially useful for transplant recipients. Methods and Results. We describe the case of a renal transplant recipient w ith a long-term stable functioning allograft who developed reversible acute renal dysfunction after beginning gabapentin therapy for chronic pain due to diabetic neuropathy. Conclusions. We suggest that gabapentin may cause acute renal dysfunction b y a mechanism involving renal afferent vasoconstriction. Caution should be employed when considering the use of gabapentin in transplant recipients, e specially when combined with other agents that may potentiate renal vasocon striction.