Document Detail

Effects of chronic lithium treatment on renal function.
MedLine Citation:
PMID:  20483164     Owner:  NLM     Status:  MEDLINE    
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.
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.
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
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
Glomerular Filtration Rate / drug effects*
Kidney Failure, Chronic / chemically induced*,  diagnosis
Kidney Function Tests
Lithium Carbonate / therapeutic use,  toxicity*
Long-Term Care
Middle Aged
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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