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Kidney function in a selected lithium population. A prospective, controlled, lithium-withdrawal study.

Acta Psychiatrica Scandinavica

|November 1, 1985

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Long-term lithium (Li) treatment impacts kidney function, causing reversible declines in glomerular and tubular function. Extended Li use may lead to permanent tubular damage, though often clinically insignificant.

Area of Science:

Nephrology
Psychopharmacology
Internal Medicine

Background:

Lithium (Li) is a widely used mood stabilizer for bipolar disorder.
Long-term lithium therapy can affect kidney function, necessitating careful monitoring.
Understanding the extent and reversibility of lithium-induced kidney changes is crucial for patient management.

Purpose of the Study:

To evaluate the effects of lithium treatment on kidney function in patients.
To compare kidney function in patients on lithium versus off lithium.
To assess the reversibility of lithium-induced renal changes after discontinuation.

Main Methods:

Studied 46 patients on long-term lithium therapy (1-11 years) both during treatment and after a 3-month washout period.
Compared kidney function parameters, including urine osmolality and urine volume, between on- and off-lithium states.

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Utilized matched pairs analysis, comparing lithium patients (on/off) with psychiatric controls (32 pairs).

Main Results:

Patients on lithium showed significantly lower urine osmolality and higher urine volume compared to controls.
Discontinuation of lithium led to improvement in both glomerular and tubular function measures.
Long-term lithium use was associated with a persistent, though often clinically insignificant, reduction in tubular function, correlated with duration of treatment.

Conclusions:

Lithium treatment causes reversible reductions in both glomerular and tubular kidney function.
Prolonged lithium exposure may result in permanent tubular damage, influenced by treatment duration.
Findings are likely generalizable to outpatient populations with similar lithium exposure and urine osmolality levels.