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Related Experiment Videos

Lithium-induced renal disease: a prospective study.

D K Jorkasky1, J D Amsterdam, J Oler

  • 1Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia.

Clinical Nephrology
|December 1, 1988
PubMed
Summary
This summary is machine-generated.

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Lithium maintenance therapy may modestly reduce kidney function in men with bipolar disorder. This prospective study found decreased creatinine clearance in male patients, but no significant changes in women or overall renal health.

Area of Science:

  • Nephrology
  • Psychiatry
  • Pharmacology

Background:

  • Lithium is a cornerstone treatment for bipolar disorder.
  • The long-term effects of lithium on renal function remain controversial.
  • Previous studies have yielded conflicting results regarding lithium-induced kidney damage.

Purpose of the Study:

  • To prospectively evaluate the impact of lithium maintenance therapy on renal function in patients with bipolar disorder.
  • To determine if lithium therapy is associated with the development of renal insufficiency.
  • To assess changes in glomerular filtration rate and renal concentrating ability.

Main Methods:

  • Prospective study design initiated in 1980.
  • Inclusion of 65 patients with bipolar disorder initiating lithium therapy, with no pre-existing renal disease.

Related Experiment Videos

  • Regular monitoring of serum creatinine, endogenous creatinine clearance (in women), and renal concentrating ability over 1 and 3 years.
  • Dose titration to the lowest effective level to avoid lithium intoxication.

    • Main Results:

    • Serum creatinine and creatinine clearance in women remained stable.
    • A statistically significant decrease in creatinine clearance was observed in men at both 1 year (p=0.0126) and 3 years (p=0.0385).
    • All patients experienced a mild, non-progressive reduction in renal concentrating ability; no changes in urinary protein excretion or urinalysis findings indicative of renal disease were noted.

    Conclusions:

    • Lithium maintenance therapy may be associated with a modest reduction in glomerular filtration rate in men with bipolar disorder.
    • The observed reduction in renal function in men does not appear to be progressive over 3 years.
    • Further investigation is required to ascertain if this reduction leads to clinically significant renal insufficiency.