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A renal function study in 30 patients on long-term lithium therapy.

A J Donker, E Prins, S Meijer

    Clinical Nephrology
    |December 1, 1979
    PubMed
    Summary
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    Long-term lithium therapy in 30 patients showed normal kidney function, with no correlation between lithium levels and urinary concentrating ability. Indomethacin improved urine concentration, suggesting lithium is safe for renal function with proper monitoring.

    Area of Science:

    • Nephrology
    • Pharmacology
    • Internal Medicine

    Background:

    • Lithium is a common mood stabilizer with potential renal side effects.
    • Assessing long-term renal function in patients on lithium therapy is crucial.

    Purpose of the Study:

    • To evaluate the renal function of patients on long-term lithium therapy.
    • To investigate the impact of lithium on urinary concentrating ability, glomerular filtration rate, and renal plasma flow.

    Main Methods:

    • Studied 30 patients on long-term lithium therapy.
    • Assessed urinary concentrating ability after water deprivation and vasopressin administration.
    • Measured glomerular filtration rate (GFR) and effective renal plasma flow (ERPF).
    • Determined minimal urine pH and urinary beta-2-microglobulin excretion.

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    Main Results:

    • Mean urine osmolality (Uosm) was 854 mOsm/kg H2O; mean GFR was 101 ml/min; mean ERPF was 360 ml/min.
    • 8 patients exhibited polyuria with slightly altered values.
    • No correlation found between Uosm and serum lithium levels.
    • GFR correlated only with age; indomethacin increased Uosm.

    Conclusions:

    • Long-term lithium treatment, with appropriate dosage and monitoring, is unlikely to cause significant renal function disturbances.
    • Lithium's effect on renal function appears manageable and not directly correlated with serum levels in this cohort.