Document Detail


Effects of chronic lithium treatment on renal function.
MedLine Citation:
PMID:  20483164     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Lithium treatment is associated with renal side effects which vary from mild nephrogenic diabetes insipidus to end stage renal disease (ESRD). A review of the literature suggests that ESRD is a very rare side effect, caused after very long-term lithium treatment, and that it might be preventable if lithium is stopped early.
METHODS: Sixty-one patients were treated with lithium for a mean of 15.6 years (range 3-32, SD=6.4). Their kidney function was monitored at an Affective Disorders Clinic for a mean of 11.5 years (range 2-29, SD=5.4). We estimated their glomerular filtration rate (eGFR) at the end of monitoring. As a control group we used 53 patients who received ECT at our hospital, and had not taken lithium, and nine patients from the same clinic who were taking other mood-stabilisers.
RESULTS: Lithium patients had lower eGFR compared to controls: 66.1 vs. 75.0 mL/min/1.73 m2, p=0.0006 after controlling for age and gender. The percentage of patients with an eGFR<60 ml/min/1.73 m2 (grade 3 chronic kidney disease) was 34.4%, vs. 13.1% in the controls, and was much increased compared to the general population in the respective age ranges. There was a modest but non-significant correlation between the number of years that patients had taken lithium and their eGFR, (beta=-0.177, B=-0.43, p=0.1). One patient reached an eGFR of 28 mL/min/1.73 m2 and her lithium was stopped. One patient required dialysis 6 years after leaving the clinic.
CONCLUSIONS: Lithium causes a modest decline in renal function. However the available research suggests that ESRD is a very rare complication of long-term lithium treatment, affecting ∼1% of patients who have taken lithium for over 15 years.
Authors:
John Tredget; Anna Kirov; George Kirov
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2010-05-16
Journal Detail:
Title:  Journal of affective disorders     Volume:  126     ISSN:  1573-2517     ISO Abbreviation:  J Affect Disord     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-09-29     Completed Date:  2011-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906073     Medline TA:  J Affect Disord     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  436-40     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier B.V. All rights reserved.
Affiliation:
MRC Centre for Neuropsychiatric Genetics and Genomics, Department of Psychological Medicine and Neurology, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antimanic Agents / therapeutic use,  toxicity*
Bipolar Disorder / drug therapy*
Creatinine / blood
Depressive Disorder, Major / drug therapy*
Diabetes Insipidus, Nephrogenic / chemically induced*,  diagnosis
Female
Glomerular Filtration Rate / drug effects*
Humans
Kidney Failure, Chronic / chemically induced*,  diagnosis
Kidney Function Tests
Lithium Carbonate / therapeutic use,  toxicity*
Long-Term Care
Male
Middle Aged
Chemical
Reg. No./Substance:
0/Antimanic Agents; 554-13-2/Lithium Carbonate; 60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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