REMOVAL OF PHENOBARBITAL DURING CONTINUOUS CYCLING PERITONEAL-DIALYSIS IN A CHILD

A 2.5-year-old child receiving phenobarbital for a history of seizures while on continuous cycling peritoneal dialysis (CCPD) had persistent subtherapeutic serum levels despite progressive dosage increases. Phe nobarbital concentration was measured in the peritoneal dialysate effl uent and peritoneal clearance was calculated. Thirty-five percent of t he total phenobarbital daily dose was being removed through 24-hour CC PD. Our findings were consistent with previous reports of 40% and 50% phenobarbital removal during continuous ambulatory peritoneal dialysis and acute peritoneal dialysis, respectively. In addition, phenobarbit al clearance was greater during the period when more exchanges were do ne compared with the period when patient went through one cycle with a longer dwell time. Based on these preliminary data, it seems that lar ger dosages of phenobarbital are necessary in patients undergoing cont inuous peritoneal dialysis, and that the amount removed can differ sig nificantly depending on the number of cycles.