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Lithium Therapy May Not Increase ESRD Risk

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Dr Ramesh Hotchandani    27 November 2017

A cohort study published in Acta Psychiatrica Scandinavica found that continuing lithium treatment after an initial diagnosis of chronic kidney disease CKD may not increase the risk of developing end stage CKD. Lithium has earlier been associated with CKD in patients with bipolar disorders. The present study evaluated if patients should continue or discontinue lithium after CKD diagnosis. Researchers used Danish health registry data to determine rates of end stage renal disease ESRD requiring dialysis or transplant and excess death risk in CKD patients taking lithium or anticonvulsants. Patients either on chronic dialysis or who underwent renal transplantation were considered to have end stage CKD. Within 10 years after a first CKD diagnosis patients on lithium or anticonvulsants had absolute rates of ESRD of 8776 20 . Among the 238 lithium recipients with diagnoses of bipolar disorder 32 remained on lithium for at least a year after CKD diagnosis. Staying on lithium decreased the ultimate risk for ESRD or death continuing or adding anticonvulsants did not affect the risk. Among the 199 bipolar disorder patients on anticonvulsants continued anticonvulsants were not associated with decreased risk but continued lithium was associated with lower risk.

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