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Renal function after long-term treatment with lithium.

R P Hullin, V P Coley, N J Birch

    British Medical Journal
    |June 2, 1979
    PubMed
    Summary
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    Long-term lithium treatment for affective disorders does not significantly impair renal function. Patients showed normal creatinine clearance and tubular function, with reduced arginine vasopressin (AVP) responsiveness.

    Area of Science:

    • Nephrology
    • Psychiatry
    • Pharmacology

    Background:

    • Lithium is a common treatment for bipolar and unipolar affective disorders.
    • Concerns exist regarding potential long-term renal impairment from lithium therapy.
    • Previous studies have suggested lithium may cause renal damage and polyuria.

    Purpose of the Study:

    • To assess renal function in patients treated with lithium.
    • To compare renal function between lithium-treated patients and those on other psychotropic drugs.
    • To investigate the effect of lithium on arginine vasopressin (AVP) responsiveness.

    Main Methods:

    • Measured daily urine volumes, plasma creatinine, and creatinine clearance in 106 patients.
    • Assessed renal tubular function, including response to water deprivation, in 30 lithium patients and 30 controls.

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  • Measured urinary arginine vasopressin (AVP) excretion.
  • Main Results:

    • Most patients had normal urine volumes, plasma creatinine, and creatinine clearance.
    • No significant differences in creatinine clearance or tubular function were found between lithium and control groups.
    • Lithium-treated patients had higher urinary AVP excretion and diminished tubular responsiveness to AVP.

    Conclusions:

    • Long-term lithium treatment does not appear to cause serious renal impairment or damage.
    • Reduced tubular responsiveness to AVP in lithium patients does not lead to significant functional deficits.
    • Low serum lithium concentrations may be effective for prophylaxis and potentially safer for renal function.