title: Novel markers of kidney injury in bipolar patients on long-term lithium treatment.
abstract: OBJECTIVE
  We assessed kidney function in long-term lithium-treated bipolar patients compared with age-matched patients not taking lithium, including novel markers of kidney injury such as plasma neutrophil gelatinase-associated lipocalin (NGAL) and urinary beta-2 microglobulin (β2-MG) METHODS: The study comprised 120 patients with bipolar disorder of which 90 (30 males and 60 females) have been receiving lithium for 5-38 (mean 16) years, and 30 (10 males and 20 females) have never been exposed to lithium.
  
  
  RESULTS
  Lithium-treated patients, both men and women, showed significantly higher plasma NGAL and urinary β2-MG and lower urine specific gravity and estimated glomerular filtration rate (eGFR), compared with patients not taking lithium. In these patients, serum NGAL did not correlate with any clinical feature or other parameter of kidney function. Urinary β2-MG correlated with serum creatinine and eGFR in the whole group of lithium-treated patients and in addition, in males, with duration of illness, duration of lithium treatment, and urine specific gravity.
  
  
  CONCLUSIONS
  Lithium treatment causes an impairment of kidney function reflected also by abnormal levels of novel markers of kidney injury. Of these, urinary β2-MG, as a marker of tubular function seems to be better predictor than serum NGAL in lithium-treated patients because it shows multiple clinical and biochemical correlations, especially in men.
authors: Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
authors: Janusz K
authors: JK
authors: Rybakowski
authors: Maria
authors: M
authors: Abramowicz
authors: Maria
authors: M
authors: Chłopocka-Wozniak
authors: Stanislaw
authors: S
authors: Czekalski
mesh_terms: D000209:Acute-Phase Proteins; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D001714:Bipolar Disorder / Q000188:drug therapy*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000503:physiopathology; D007677:Kidney Function Tests; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood; D018020:Lithium Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000097:blood; D012737:Sex Factors; D013997:Time Factors; D001613:beta 2-Microglobulin / Q000652:urine
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D018020:Lithium Compounds; D011518:Proto-Oncogene Proteins; D001613:beta 2-Microglobulin
keywords: beta-2 microglobulin (β2-MG); creatinine; glomerular filtration rate (GFR); kidney; lithium; neutrophil gelatinase-associated lipocalin (NGAL)