[Progressive renal failure caused by lithium nephropathy].
OBJECTIVE
Study the renal consequences of lithium therapy and find out whether lithium-induced chronic renal toxicity can provoke a progressive nephropathy, leading to advanced renal failure, requiring periodical dialysis.


METHODS
Fifty-three patients treated with long-term lithium salts were included in the study. They had developed chronic renal failure (creatinine clearance inferior to 80 ml/min) not due to any other cause.


RESULTS
These patients had received lithium salts for a mean period of 17.7 years. The mean reduction in creatinine clearance was of 2.23 ml/min/year. Final clearance correlated negatively with the duration of lithium administration. In 7 patients treated a mean of 22 years, progression towards terminal kidney failure required periodical dialysis. Around 30% of patients exhibited mild hypercalcemia.


CONCLUSIONS
Lithium nephropathy inducing progressive renal failure is a reality. Its prevalence in patients treated long-term with lithium should be assessed.
Presne
C
C
Service de Néphrologie adulte, Hôpital Necker, 161 rue de sèvres, 75743 Paris.
Fakhouri
F
F
Kenouch
S
S
Stengel
B
B
Kreis
H
H
Grünfeld
J P
JP
D000328:Adult; D001714:Bipolar Disorder / Q000097:blood / Q000188:drug therapy*; D003404:Creatinine / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis; D007677:Kidney Function Tests; D018020:Lithium Compounds / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
D018020:Lithium Compounds; D003404:Creatinine