Renal effects of long-term lithium therapy, revisited

YAZICI M. S., ÖZÇELİK EROĞLU E., ERTUĞRUL A., ANIL YAĞCIOĞLU A. E., Ağaoğlu E., KARAHAN S., ...Daha Fazla

Human Psychopharmacology, cilt.37, sa.2, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 37 Sayı: 2
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1002/hup.2812
  • Dergi Adı: Human Psychopharmacology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Psycinfo, Veterinary Science Database
  • Anahtar Kelimeler: kidney function, lithium, nephrotoxicity, proteinuria, urine protein, creatinine ratio, DISEASE, MANAGEMENT, DISORDERS
  • Karadeniz Teknik Üniversitesi Adresli: Evet

Özet

© 2021 John Wiley & Sons Ltd.Objective: The aim of this study was to investigate the effect of lithium treatment on renal function and to determine influencing factors. In addition, the utility of spot urine protein/creatinine ratio in detection of lithium induced nephropathy was also investigated. Methods: Serum concentrations of lithium, blood urea nitrogen (BUN), creatinine, estimated glomerular filtration rate (eGFR), and urinalysis including protein/creatinine ratio were measured in 375 patients using lithium. Results: Patients taking lithium for ≥8 years had higher BUN, creatinine levels, percentage of proteinuria, percentages of stage 2 and 3 chronic kidney disease (CKD); lower urine density and eGFR compared to patients taking lithium <8 years. Urine density was lower in groups with >0.8 and 0.6–0.8 mmol/L lithium level than <0.6 mmol/L. Predictors of CKD were serum level of lithium, dose of lithium, cumulative duration of lithium use, age at onset of illness, and caffeine consumption. Conclusions: Detrimental effects of lithium on renal functions were detected after lithium use for ≥8 years. Proteinuria measured by spot urine protein/creatinine ratio can be detected even when eGFR is >90 ml/min/1.73 m2. Spot urine protein/creatinine ratio, which is a cost-effective and practical laboratory test, can be used to monitor lithium-treated patients.