Lithium Therapy May Not Increase ESRD Risk

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In the subcohorts of patients with a diagnosis of bipolar disorder, continuing lithium was associated with decreased end-stage CKD, whereas continuing anticonvulsants was not.
In the subcohorts of patients with a diagnosis of bipolar disorder, continuing lithium was associated with decreased end-stage CKD, whereas continuing anticonvulsants was not.

Results of a cohort study found that continuing lithium treatment after an initial diagnosis of chronic kidney disease (CKD) may not increase the risk of developing end-stage CKD.

The study included “all individuals in Denmark in a period from 1995 to 2012 with a diagnosis of CKD and (i) a history of lithium treatment (N=754, among whom 238 patients had a diagnosis of bipolar disorder) or (ii) a history of anticonvulsant treatment (N=5,004, among whom 199 patients had a diagnosis of bipolar disorder).” Patients either on chronic dialysis or who underwent renal transplantation were considered to have end-stage CKD. 

Results of the study found that continuing lithium therapy was associated with a decreased rate of end-stage CKD (HR: 0.58; 95% CI: 0.37, 0.90). Additionally, a decreased rate of end-stage CKD was also seen in patients who continued anticonvulsant therapy (HR: 0.53; 95% CI: 0.44, 0.64). The study authors added, “In the subcohorts of patients with a diagnosis of bipolar disorder, continuing lithium was associated with decreased end-stage CKD (HR = 0.40 (95% CI: 0.17-0.98), whereas continuing anticonvulsants was not (HR = 0.70 (95% CI: 0.21-2.37).”  No interactions of lithium and anticonvulsants were observed.

According to results of this study, continuing either lithium or anticonvulsant therapy following an initial diagnosis of CKD may not increase the risk of end-stage CKD development. 

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