Lithium-induced nephropathy: Rate of progression and prognostic factors

Presne, Claire; Fakhouri, Fádi; Nôël, Laure-Hélène; Stengel, Bénédicte; Even, C.; Kreis, Henri; Mignon, Françoise; Grünfeld, Jean‐Pierre

doi:10.1046/j.1523-1755.2003.00096.x

Cited by 184 publications

(169 citation statements)

References 31 publications

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“…This side effect is commonly underreported, unless it is directly inquired about 817. Long‐term administration (ie, 10‐20+ years) is further associated with decreased glomerular filtration rate and chronic kidney disease 818. While long‐term lithium administration is probably an important risk factor for developing chronic kidney disease, factors that may increase susceptibility include higher plasma lithium levels, multiple daily lithium doses (vs once daily), concurrent medications (eg NSAIDs, ARBs, ACEIs and diuretics), somatic illnesses (eg, hypertension, diabetes mellitus and coronary artery disease) and older age 819, 820.…”

Section: Safety and Monitoringmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

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Section: Safety and Monitoringmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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“…In addition, long-term lithium treatment itself can cause nephropathy. 7 Careful monitoring of the renal function throughout the study period did not reveal any renal toxic effect. No patient complained of or found to have polyuria, electrode disturbance, albuminuria or impaired renal function test.…”

Section: Discussionmentioning

confidence: 88%

A three-month, open-label, single-arm trial evaluating the safety and pharmacokinetics of oral lithium in patients with chronic spinal cord injury

Wong

Tam

et al. 2010

Spinal Cord

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Objectives: Lithium has recently been found to enhance neuronal regeneration and differentiation. This arouses its potential use to treat spinal cord injury patients. The safety and pharmacokinetics of lithium are not verified for this group of patients as their internal organ functions may change. This is a phase 1 clinical trial to evaluate the safety and pharmacokinetics of lithium in spinal cord injury patients. Methods: A total of 20 chronic spinal cord injury subjects were recruited. Oral lithium carbonate was given in divided dose to maintain the serum lithium level 0.6-1.2 mmol l À1 for 6 weeks. Safety parameters, adverse events and pharmacokinetic data were carefully collected and monitored. Results: No severe adverse event was documented. All blood parameters remained stable. Nausea and vomiting were the most common complaints but tolerance was improved in 2 weeks for most subjects. A wide range of oral doses was required to maintain serum lithium level at the targeted range. However, the dose for individual subject was relatively constant. Conclusion: This phase 1 clinical trial is the first report indicating the safety of lithium in chronic spinal cord injury patients. It is well tolerated after the first 2 weeks. Individual titration of lithium is essential to maintain an optimal serum lithium level but once the desirable level is achieved, the oral dose remains relatively unchanged for maintenance.Spinal Cord (2011) 49, 94-98;

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“…The risk of developing CKD in patients on long-term lithium treatment has now been well established by several clinical, histopathological and epidemiological studies 7,19,24 . A French study of 54 patients with lithium-induced nephropathy demonstrated a mean annual loss of creatinine clearance of 2.29 mL/min 24 .…”

Section: Lithium-induced Nephropathy and Chronic Kidney Disease (Ckd)mentioning

confidence: 99%

“…A French study of 54 patients with lithium-induced nephropathy demonstrated a mean annual loss of creatinine clearance of 2.29 mL/min 24 . In that country, the prevalence of lithium-related chronic end-stage renal disease (ESRD) is estimated as 2 per 1000 dialysis patients, accounting for 0.22% of all ESRD cases 24 .…”

Section: Lithium-induced Nephropathy and Chronic Kidney Disease (Ckd)mentioning

confidence: 99%

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Nefrotoxicidade por lítio

Oliveira¹,

Júnior²,

Abreu³

et al. 2010

Rev. Assoc. Med. Bras.

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Lithium has been widely used in the treatment of bipolar disorder. Its renal toxicity includes impaired urinary concentrating ability and natriuresis, renal tubular acidosis, tubulointerstitial nephritis progressing to chronic kidney disease and hypercalcemia. The most common adverse effect is nephrogenic diabetes insipidus, which affects 20-40% of patients within weeks of lithium initiation. Chronic nephropathy correlates with duration of lithium therapy. Early detection of renal dysfunction should be achieved by rigorous monitoring of patients and close collaboration between psychiatrists and nephrologists. Recent experimental and clinical studies begin to clarify the mechanisms by which lithium induces changes in renal function. The aim of this study was to review the pathogenesis, clinical presentation, histopathological aspects and treatment of lithium-induced nephrotoxicity.

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Lithium-induced nephropathy: Rate of progression and prognostic factors

Cited by 184 publications

References 31 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

A three-month, open-label, single-arm trial evaluating the safety and pharmacokinetics of oral lithium in patients with chronic spinal cord injury

Nefrotoxicidade por lítio

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