Renal function after withdrawal of lithium.

Autor: Hoekstra R; Outpatient Clinic for Bipolar Disorders, Antes Center for Mental Health Care, Rotterdam, The Netherlands., Lekkerkerker MN; GGZ Delfland, Delft, The Netherlands., Kuijper TM; Maasstad Academy, Maasstad Hospital, Rotterdam, The Netherlands., Bosch TM; Department of Hospital Pharmacy, Maasstad Hospital, Rotterdam, The Netherlands., van Alphen AM; Department of Internal Medicine and Nephrology, Maasstad Hospital, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Bipolar disorders [Bipolar Disord] 2022 Sep; Vol. 24 (6), pp. 667-670. Date of Electronic Publication: 2022 Feb 01.
DOI: 10.1111/bdi.13178
Abstrakt: Objectives: Patients on chronic lithium therapy sometimes develop chronic kidney disease. For clinical decision-making, it is important to know whether discontinuation of lithium can lead to improvement of renal function. We studied the trajectory of renal function in a population previously on chronic lithium therapy.
Methods: From a large database of patients on chronic lithium therapy, we selected a group of patients who stopped using lithium and whose creatinine values at least half a year after lithium withdrawal were available. We measured the slope of renal function (eGFR) before and after discontinuation of lithium. We compared the subgroup of patients with improvement of the renal function with those who showed further deterioration of the eGFR.
Results: eGFR slope significantly improved after discontinuation of lithium. Of patients with chronic kidney disease stage 3 or more (eGFR<60 ml/min), the vast majority showed an increase of eGFR or a decrease in the rate of decline after lithium withdrawal. The group of patients with further deterioration of the renal function had a mean eGFR of 32 ml/min, which was significantly lower than the patients with an improvement of the kidney function.
Conclusions: Discontinuation of lithium leads in the majority of patients to improvement in renal function or at least less rapid deterioration.
(© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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