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A historical cohort study of kidney damage in long-term lithium patients: continued surveillance needed

Published online by Cambridge University Press:  16 April 2020

H. Bendz ,
M. Aurell  and
J. Lanke
H. Bendz*
Affiliation:
Department of Clinical Neuroscience, Psychiatry section, Lund University, Lund, Sweden;
M. Aurell
Affiliation:
Department of Nephrology, Gothenburg University, Gothenburg, Sweden;
J. Lanke
Affiliation:
Department of Statistics, Lund University, Lund, Sweden
*
*Correspondence and reprints: Department of Psychiatry, University Hospital, S-221 85 Lund, Sweden
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Summary

Background

Insufficient knowledge on the longitudinal fate of renal function in lithium patients incited this retrospective study of 149 patients.

Method

Medical record review of a lithium cohort (N = 149), 8–12 years after an initial renal function study.

Results

Twenty-one patients had died, one from uremia probably not caused by lithium, and 42 had discontinued lithium. Reduced urinary concentrating capacity (Umax) or glomerular filtration rate (GFR) was not more frequent among deceased or off-lithium patients than among the 86 patients who were on lithium at follow-up. In 63 of the latter patients, Umax had been re-examined after the initial study, and GFR in 29 patients. Reduced Umax and GFR had become twice as common, and average Umax and GFR had decreased significantly. The reduction of GFR was associated with lithium treatment duration and age, and reduced Umax with treatment duration only.

Conclusions

Reduced renal function is not a major cause of treatment discontinuation but becomes increasingly common with treatment duration.

Keywords

lithiumlongitudinal studynephropathyrenal functionside effects
Type
Original article
Information
European Psychiatry , Volume 16 , Issue 4 , June 2001 , pp. 199 - 206
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2001

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References

Anonymous Dåligt känd litiumbiverkan vid operation orsakade kvinnas död. (Poorly known side-effect of lithium caused a woman’s death). Läkartidningen 1996; 92: 3924–3924.Google Scholar
Aurell, M., Svalander, C., Wallin, L., Alling, C.Renal function and biopsy findings in patients on long-term lithium-treatment. Kidney Int 1981; 20: 663–670.CrossRefGoogle ScholarPubMed
Azam, H., Newton, R.W., Morris, A.D., Thompson, C.J.Hyperosmolar nonketotic coma precipitated by lithium-induced nephrogenic diabetes insipidus. Postgrad Med J 1998; 74: 39–46.CrossRefGoogle ScholarPubMed
Bendz, H., Andersch, S., Aurell, M.Kidney function in an unselected lithium population. A cross-sectional study. Acta Psychiatr Scand 1983; 68: 303–324.CrossRefGoogle Scholar
Bendz, H.Kidney function in lithium-treated patients. A literature survey. Acta Psychiatr Scand 1983; 68: 325–334.CrossRefGoogle ScholarPubMed
Bendz, H., Andersch, S., Aurell, M.Kidney function in a selected lithium population. A prospective, controlled, lithium withdrawal study. Acta Psychiatr Scand 1985; 72: 451–463.CrossRefGoogle Scholar
Bendz, H.A case of solute diuresis erroneously diagnosed as lithium-induced diabetes insipidus. Acta Psychiatr Scand 1985; 71: 92–93.CrossRefGoogle Scholar
Bendz, H., Aurell, M., Balldin, J., Sjödin, I.Kidney damage in long-term lithium patients. A cross-sectional study of patients with 15 years or more on lithium. Nephrol Dial Transplant 1994; 9: 1250–1254.Google ScholarPubMed
Bendz, H., Sjödin, I., Aurell, M.Renal function on and off lithium in patients treated with lithium for 15 years or more. A controlled, prospective lithium-withdrawal study. Nephrol Dial Transplant 1996; 11: 457–460.CrossRefGoogle ScholarPubMed
Bendz, H., Sjödin, I., Toss, G., Berglund, K.Hyperparathyroidism and long-term lithium therapy – a cross-sectional study and the effect of lithium withdrawal. J Int M 1996; 240: 357–365.CrossRefGoogle ScholarPubMed
Boton, R., Gaviria, M., Batlle, D.C.Prevalence, pathogenesis, and treatment of renal dysfunction associated with chronic lithium therapy. Am J Kidney Dis 1987; 10: 329–345.CrossRefGoogle ScholarPubMed
Bröchner-Mortensen, J.A simple method for the determination of glomerular filtration rate. Scand J Clin Lab Invest 1972; 30: 271–274.CrossRefGoogle ScholarPubMed
Bucht, G., Wahlin, A.Renal concentrating capacity in long-term lithium treatment and after withdrawal of lithium. Acta Med Scand 1980; 207: 309–314.CrossRefGoogle ScholarPubMed
Cuesta, M.J., Perez-Nievas, F., Hernandez, R., Lanzas, G., Peralta, V.Neuroleptic malignant syndrome following a lithium-induced nephrogenic diabetes insipidus. Eur Psychiatry 1996; 11: 325–326.CrossRefGoogle ScholarPubMed
Daisley, H., Barton, E.N., Williams, C.T.Fatal lithium toxicity during a religious fast. South Med J 1990; 83: 364–364.CrossRefGoogle ScholarPubMed
Delin, K., Aurell, M., Ewald, J.Urinary concentration test with desmopressin. Br Med J 1978; 1: 757–758.CrossRefGoogle ScholarPubMed
de Paulo, J.R. Jr, Cohen, M.J., Correa, E.I., Sapir, D.G.Letter to the editor. Am J Psychiatry 1987; 144: 823–823.Google Scholar
Gitlin, M.J.Lithium-induced renal insufficiency. J Clin Pharmacology 1993; 13: 276–279.Google ScholarPubMed
Gitlin, M.J.Lithium and the kidney. An updated review. Drug Safety 1999; 20: 231–243.CrossRefGoogle ScholarPubMed
Gray, E.J., Dierks, E.J.Lithium-induced diabetes insipidus in a surgical patient: report of a case and review of the literature. J Oral Maxillofac Surg 1996; 54: 909–912.CrossRefGoogle Scholar
Granérus, G., Aurell, M.Reference values for 51 Cr-EDTA clearance as a measure of glomerular filtration rate. Scand J Clin Lab Invest 1981; 41: 611–616.CrossRefGoogle Scholar
Grindlinger, G.A., Boylan, M.J.Amelioration by indomethazin of lithium-induced polyuria. Crit Care M 1987; 15: 538–539.CrossRefGoogle Scholar
Hansen, H.E.Lithium intoxication. (Report of 23 cases and review of 100 cases from the literature). Q J M 1978; 47: 123–144.Google Scholar
Hansen, H.E.Renal toxicity of lithium. Drugs 1981; 22: 461–476.CrossRefGoogle ScholarPubMed
Hestbech, J., Hansen, H.E., Amdisen, A., Olsen, S.Chronic renal lesions following long-term treatment with lithium. Kidney Int 1977; 12: 205–213.CrossRefGoogle ScholarPubMed
Hetmar, O., Juul Povlsen, U., Ladefoged, J., Bolwig, T.Lithium: long-term effects on the kidney. A prospective follow-up study ten years after kidney biopsy. Br J Psychiatry 1991; 158: 53–58.CrossRefGoogle ScholarPubMed
Himmelhoch, J.M.On the failure to recognize lithium failure. Psychiatric Ann 1994; 24: 241–250.CrossRefGoogle Scholar
Johnson, M.A., Ogorman, J., Golembiewski, G.H., Paluzzi, M.W.Nephrogenic diabetes insipidus secondary to lithium therapy in the postoperative patient: a case report. Am Surg 1994; 60: 836–839.Google ScholarPubMed
MacDonald, K.J., Little, P.J., Bailey, R.R.Lithium and the kidney. NZ Med J 1979; 90: 323–325.Google ScholarPubMed
MacGregor, D.A., Baker, A.M., Appel, R.G., Ober, K.P., Zaloga, G.P.Hyperosmolar coma due to lithium-induced diabetes insipidus. Lancet 1995; 346: 413–417.CrossRefGoogle Scholar
Markowitz, G.S., Radhakrishnan, J., Kambham, N., Valeri, A.M., Hines, W.H., d’Agati, V.Lithium toxicity: a progressive combined glomerular and tubulointerstitial nephropathy. J Am Soc Nephrol 2000; 11: 1439–1448.Google ScholarPubMed
Meinardi, J.R., Donders, S.H.J.Nephrogenic diabetes insipidus in a lethargic lithium-treated patient. Neth J M 1997; 50: 105–109.CrossRefGoogle Scholar
Nilsson, A., Axelsson, R.Effects of long-term lithium treatment on thyroid and renal function (serum creatinine and maximal urine osmolality) – a prospective study in psychiatric patients. Curr Ther Res 1989; 46: 85–102.Google Scholar
Page, C., Benaim, S., Lappin, F.A long-term retrospective follow-up study of patients treated with prophylactic lithium carbonate. Br J Psychiatry 1987; 150: 175–179.CrossRefGoogle ScholarPubMed
Schou, M., Vestergaard, P.Prospective studies on a lithium cohort. 2. Renal function. Water and electrolyte metabolism. Acta Psychiatr Scand 1988; 78: 427–433.CrossRefGoogle ScholarPubMed
Schou, M.Lithium treatment and kidney function. Clinical observationsChristensen, S., Lithium and the kidney Basel: Karger; 1990; p. 143–154.Google Scholar
Thompson, C.J., France, A.J., Baylis, P.H.Persistent nephrogenic diabetes insipidus following lithium therapy. Scott Med J 1997; 42: 16–17.CrossRefGoogle ScholarPubMed
Tryding, N., Berg, B., Ekman, S., Nilsson, J.E., Sterner, G., Harris, A.DDAVP test for renal concentration capacity. Age-related reference intervals. Scand J Urol Nephrol 1988; 22: 141–145.CrossRefGoogle ScholarPubMed
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