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A double-blind, randomized, placebo-controlled pilot trial of atorvastatin for nephrogenic diabetes insipidus in

Jocelyn Fotso Soh1,2, Serge Beaulieu2, Francesco Trepiccione3

  • 1Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada.

Bipolar Disorders
|July 5, 2020
PubMed
Abstract

Insights

Atorvastatin did not significantly improve urinary osmolality in lithium-induced nephrogenic diabetes insipidus (NDI) over 12 weeks. Further trials are needed to assess statin efficacy for NDI, particularly in severe cases.

Area of Science:

  • Nephrology
  • Pharmacology
  • Endocrinology

Background:

  • Lithium is crucial for mood disorders but linked to kidney disease, specifically nephrogenic diabetes insipidus (NDI).
  • NDI significantly increases the risk of chronic kidney disease in lithium users.
  • Limited treatment options exist for lithium-induced NDI, with current therapies often poorly tolerated.

Purpose of the Study:

  • To evaluate the feasibility and efficacy of atorvastatin in treating NDI in chronic lithium users.
  • To assess the impact of 20 mg/day atorvastatin versus placebo on urinary osmolality and fluid balance.

Main Methods:

  • A 12-week, double-blind, placebo-controlled pilot randomized controlled trial (RCT).
  • Recruited adult patients (18-85 years) on stable lithium doses with confirmed NDI.
  • Measured urinary osmolality, fluid intake, and aquaporin-2 excretion as primary and secondary outcomes.

Main Results:

  • No statistically significant difference in urinary osmolality between atorvastatin and placebo groups at 12 weeks.
  • Secondary outcomes for fluid intake and aquaporin-2 excretion also showed no significant differences.
  • A moderate effect size for improvement in urinary osmolality (≥100 mOsm/kg) was observed with atorvastatin compared to placebo.

Conclusions:

  • Atorvastatin (20 mg/day) did not significantly improve urinary osmolality in lithium-associated NDI over 12 weeks.
  • Larger, longer-term trials are warranted to explore statin effects on NDI, especially in patients with more severe disease.
  • The findings highlight the need for novel therapeutic strategies for lithium-induced NDI.
Keywords:
bipolar disorderkidney functionlithium usenephrogenic diabetes insipidus

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