title: End-stage renal disease associated with prophylactic lithium treatment.
abstract: The primary aim of this study was to estimate the prevalence of lithium associated end-stage renal disease (ESRD) and to compare the relative risk of ESRD in lithium users versus non-lithium users. Second, the role of lithium in the pathogenesis of ESRD was evaluated. We used the Swedish Renal Registry to search for lithium-treated patients with ESRD among 2644 patients with chronic renal replacement therapy (RRT)-either dialysis or transplantation, within two defined geographical areas in Sweden with 2.8 million inhabitants. The prevalence date was December 31, 2010. We found 30 ESRD patients with a history of lithium treatment. ESRD with RRT was significantly more prevalent among lithium users than among non-lithium users (p<0.001). The prevalence of ESRD with RRT in the lithium user population was 15.0‰ (95% CI 9.7-20.3), and close to two percent of the RRT population were lithium users. The relative risk of ESRD with RRT in the lithium user population compared with the general population was 7.8 (95% CI 5.4-11.1). Out of those 30 patients, lithium use was classified, based on chart reviews, as being the sole (n=14) or main (n=10) cause of ESRD in 24 cases. Their mean age at the start of RRT was 66 years (46-82), their mean time on lithium 27 years (12-39), and 22 of them had been on lithium for 15 years or more. We conclude that lithium-associated ESRD is an uncommon but not rare complication of lithium treatment.
authors: Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: harald.aiff@vgregion.se.
authors: Harald
authors: H
authors: Aiff
authors: Department of Nephrology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: Per-Ola
authors: PO
authors: Attman
authors: Department of Nephrology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: Mattias
authors: M
authors: Aurell
authors: Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden.
authors: Hans
authors: H
authors: Bendz
authors: Diaverum Renal Services Group, Lund & Swedish Renal Registry, Jönköping, Sweden.
authors: Staffan
authors: S
authors: Schön
authors: Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: Jan
authors: J
authors: Svedlund
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018692:Antimanic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000139:chemically induced* / Q000453:epidemiology / Q000628:therapy; D008094:Lithium / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D015995:Prevalence; D012042:Registries; D012306:Risk; D055502:Secondary Prevention; D013548:Sweden / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents; D018692:Antimanic Agents; D008094:Lithium
keywords: Adverse effects; Affective disorders; Chronic; Kidney failure; Lithium