Hemodialysis for Lithium Poisoning

SummaryThree patients with lithium toxicity are reported, two of whom were exposed to toxic lithium levels for a prolonged period: both survived with permanent damage to basal ganglia and cerebellar connexions despite effective lowering of lithium levels by haemodialysis. Data obtained during dialysis treatment show prolonged haemodialysis to be the treatment of choice. If facilities for haemodialysis are not available or the patient presents with toxic lithium levels and miimal symptoms peritoneal dialysis will effectively lower serum lithium levels, but more slowly than haemodialysis.

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“…Serum lithium levels during and after haemodialysis compared with case ofAmdisen and Skjoldborg, 1969. …”

mentioning

confidence: 99%

Permanent Neurological Sequelae Despite Haemodialysis for Lithium Intoxication

Hartitzsch¹,

Hoenich²,

Leigh³

et al. 1972

BMJ

103

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“…One case has been reported in which severe intoxication was associated with uraemia, which responded to fluid infusion (Verbov, Phillips & Fife, 1965). Two cases of acute renal failure associated with lithium toxicity have been reported (Hawkins & Dorken, 1969;Amdisen & Skoldborg, 1969). In the first acute renal failure may have been related to hypotension, but in the second no cause was found.…”

Section: Discussionmentioning

confidence: 99%

Acute renal failure and lithium intoxication

Lavender

Brown

Berrill

1973

Postgraduate Medical Journal

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Summary A case of acute renal failure is reported in a patient with severe lithium intoxication. Renal biopsy showed damage in the proximal tubules with less marked changes in the glomeruli and interlobular arteries. Lithium was withdrawn, and after treatment with peritoneal dialysis the patient regained normal renal function. The accumulation of lithium is known to lead to acute renal failure in the rat and the dog, and this report provides further evidence that it may do so in man.

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“…The fraction of elimination by hemodialysis was calculated for subjects in the ESRD group as the difference between the observed and extrapolated predialysis LY2605541 serum concentrations relative to the observed predialysis LY2605541 serum concentration 15. The extrapolated predialysis concentration was derived from the linearly fit line on the semilogarithmic plot of the terminal phase.…”

Section: Methodsmentioning

confidence: 99%

Pharmacokinetics of the Long‐Acting Basal Insulin LY2605541 in Subjects With Varying Degrees of Renal Function

Linnebjerg

Choi

Lam

et al. 2016

Clinical Pharm in Drug Dev

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The pharmacokinetics of LY2605541 (basal insulin peglispro), a novel long‐acting basal insulin analogue, was evaluated in 5 groups of subjects with varying degrees of renal function based on creatinine clearance: normal renal function (>80 mL/min), mild renal impairment (51–80 mL/min), moderate renal impairment (30–50 mL/min), severe renal impairment (<30 mL/min), or end‐stage renal disease (ESRD) requiring hemodialysis. Serial blood samples for pharmacokinetic analyses were collected up to 12 days following a single 0.33 U/kg subcutaneous dose of LY2605541. The apparent clearance (CL/F) and half‐life across groups were not affected by renal function. Cmax values were lower in subjects with increasing severity of renal impairment; however, the small decrease in Cmax did not affect the overall exposure. Regression analysis showed that LY2605541 clearance is independent of renal function (slope = 0.000863; P = .885). The mean fraction of LY2605541 eliminated by a single hemodialysis session was 13% in subjects with ESRD. LY2605541 was generally well tolerated in healthy subjects and those with renal impairment following a single 0.33 U/kg subcutaneous dose. Given these data, no dose adjustment of LY2605541 based on pharmacokinetics is recommended in renal impairment or in patients undergoing hemodialysis.

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Hemodialysis for Lithium Poisoning

Cited by 65 publications

References 3 publications

Permanent Neurological Sequelae Despite Haemodialysis for Lithium Intoxication

Permanent Neurological Sequelae Despite Haemodialysis for Lithium Intoxication

Acute renal failure and lithium intoxication

Pharmacokinetics of the Long‐Acting Basal Insulin LY2605541 in Subjects With Varying Degrees of Renal Function

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