More than 50 million individuals worldwide suffer from epilepsy, and concomitant conditions including decreased renal function can make managing the condition more difficult. It has been proven in many studies that the probability of convulsions is high in patients with kidney failure. Clinicians must understand how antiepileptic medications (AEDs) are influenced by decreased renal function and how epilepsy management strategies are affected by the kidneys in order to maximize epilepsy control in patients with kidney illness. On the otherhand, seizures are brought on in patient with renal failure by the buildup of toxins as well as by other conditions such as sepsis, hemorrhage, malignant hypertension, metabolic disturbances, and electrolyte abnormalities, acute dysequilibrium syndrome. Some antibiotics lower convulsive thresholds, putting patients at risk for status epilepticus. A thorough understanding of AED metabolism, their pharmacokinetic alterations in such disorders, careful use of concurrent drugs, and monitoring of AED serum levels are all necessary for effective seizure management in renal diseases. We wanted to remind the problems we face as clinicians and their solutions by reviewing the articles related to this review.