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Duration of Lithium Therapy Unrelated to Renal Impairment: Presented at APA

By Charlene Laino

WASHINGTON, DC -- May 13, 2008 -- The duration of lithium treatment is not related to the risk of renal impairment among bipolar patients, according to a study presented here at the 161st Annual Meeting of the American Psychiatric Association (APA).

Impaired renal function is a well-established adverse effect of lithium treatment, said investigator Vidis Donnelly, MD, Researcher, Department of Psychiatry, St. Patrick's Hospital, Dublin, Ireland. But studies looking at duration of exposure and risk of renal impairment have had conflicting results.

To determine the relationship between duration of treatment and risk of renal impairment, Dr. Donnelly and colleagues analyzed the medical records of all 1,280 patients prescribed lithium at St. Patrick's Hospital in 2006. The study is the largest to date to examine the relationship, she said in a presentation on May 5.

Patients' serum creatinine levels were obtained and were used with each patient's age and gender to estimate the glomerular filtration rate (GFR). Normal renal function was defined as an estimated GFR of >80 mL/min/1.73 m².

Rates of moderate renal impairment, defined as an estimated GFR of 30 to 59 mL/min/1.73 m², were:
· 33.5% in 331 patients taking lithium for <=18 months.
· 30.2% in 149 patients taking lithium for 18 months to 3 years.
· 34.4% in 212 patients taking lithium for 3 to 6 years.
· 33.6% in 235 patients taking lithium for 6 to 10 years.
· 49.3% in 353 patients taking lithium for >10 years.

Rates of severe renal impairment, defined as an estimated GFR <30 mL/min/1.73 m², were:
· 0% in 331 patients taking lithium for <=18 months.
· 0% in 149 patients taking lithium for 18 months to 3 years.
· 0.5% in 212 patients taking lithium for 3 to 6 years.
· 0.8% in 235 patients taking lithium for 6 to 10 years.
· 1.7% in 353 patients taking lithium for >10 years.

There was an insignificant Pearson correlation coefficient of -0.23 between duration of treatment and estimated GFR, Dr. Donnelly said.

These findings suggest that renal function should be monitored regularly, regardless of how long a patient has been taking lithium, Dr. Donnelly said.


[Presentation title: Lithium: Duration on Treatment and Correlation With Renal Impairment. Abstract NR1-070]

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