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Reconsidering risk factors for renal dysfunction in lithium-treated patients
  1. Alberto Bocchetta
  1. Correspondence to Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy; bocchett{at}unica.it

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ABSTRACT FROM: Clos S, Rauchhaus P, Severn A, et al. Long-term effect of lithium maintenance therapy on estimated glomerular filtration rate in patients with affective disorders: a population-based cohort study. Lancet Psychiatry 2015;2:1075–83.

What is already known on this topic

Over the past 6 years, a series of studies have investigated risk factors for renal dysfunction in lithium-treated patients, following the 2010's report that end-stage renal disease is an uncommon but not rare consequence of long-term lithium treatment and is more prevalent than previously thought.1 Besides risk factors already known to be involved in renal dysfunction, such as age, hypertension, diabetes and use of non-steroidal anti-inflammatory drugs, there may be additional risk factors specific for this context, including receiving a diagnosis of bipolar disorder, the principal indication of lithium maintenance. The latter possibility was suggested by a recent Danish nationwide population-based study whose aim was to compare rates of chronic kidney disease (CKD) among individuals exposed to lithium, individuals exposed to anticonvulsants and other drugs used for bipolar disorders.2

Methods of the study

This was a population-based cohort study of patients (18–65 years of age at baseline) registered with a regional family doctor in Tayside (Scotland, UK) who had started for the first time, between 2000 and 2011, using lithium or other first-line drugs (quetiapine, olanzapine and valproate) as long-term treatment for affective disorders (International Classification of Diseases, 10th Revision (ICD-10) diagnosis F30–F39: manic episode, …

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