Baclofen Neurotoxicity in a Pediatric Patient on Peritoneal Dialysis

We describe a 2-year-old patient with End Stage Kidney Disease (ESKD) on Continuous Cycling Peritoneal Dialysis (CCPD), gastroesophageal reflux disease, gastric tube dependence who presented with hypotension, confusion and lethargy 1 day after initiating oral baclofen for chronic vomiting. Sepsis work up and baclofen level were sent, later showing baclofen level of 0.55 mcg/ml. The patient required norepinephrine and CCPD for 24 hours before returning to baseline. CCPD was continued for 33 hours and he was discharged home at baclofen level of 0.25 mcg/mL.