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Lithium: long-term effects on the kidney--II. Structural changes.

O Hetmar1, C Brun, L Clemmesen

  • 1Department of Psychiatry, Rigshospitalet, Copenhagen, Denmark.

Journal of Psychiatric Research
|January 1, 1987
PubMed
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Lithium treatment may affect kidney health, increasing risks of glomeruli sclerosis and tubular atrophy. Dividing lithium doses increases these risks compared to single daily doses, impacting kidney pathology.

Area of Science:

  • Nephrology
  • Pharmacology
  • Histopathology

Background:

  • Lithium is a common mood stabilizer for bipolar disorder.
  • Long-term lithium use can have various side effects.
  • Kidney function is a key concern in lithium therapy.

Purpose of the Study:

  • To investigate the long-term effects of lithium on kidney histology.
  • To compare kidney biopsies of lithium-treated patients with controls.
  • To correlate histopathological changes with lithium dosage regimens.

Main Methods:

  • Kidney biopsies from 46 lithium-treated patients (average 8 years) were analyzed.
  • Biopsies were compared to age-matched controls.
  • Histopathological changes were quantified and correlated with lithium dosage schedules.

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Main Results:

  • Lithium-treated patients showed higher rates of sclerotic glomeruli and atrophic tubules.
  • Histopathological changes correlated significantly with lithium dosage.
  • More frequent dosing (2-3 times/day) was associated with higher proportions of sclerotic glomeruli, atrophic tubules, and interstitial fibrosis compared to single daily doses.

Conclusions:

  • Long-term lithium therapy is associated with adverse kidney changes.
  • Lithium dosage frequency, not just cumulative dose, influences renal histopathology.
  • Optimizing lithium dosing schedules may mitigate kidney damage risk.