Renal function after withdrawal of lithium

• Published in: Bipolar disorders Vol. 24; no. 6; pp. 667 - 670
• Main Authors: Hoekstra, Rocco, Lekkerkerker, Marius N., Kuijper, Tjallingius M., Bosch, Tessa M., Alphen, Arjan M.
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.09.2022
• Subjects: chronic kidney disease; Creatinine; Decision making; discontinuation; Epidermal growth factor receptors; glomerular filtration rate; Kidney diseases; Lithium; Patients; Renal function; renal insufficiency; lithium; chronic kidney disease; glomerular filtration rate; discontinuation; renal insufficiency
• ISSN: 1398-5647; 1399-5618
• DOI: 10.1111/bdi.13178

Objectives Patients on chronic lithium therapy sometimes develop chronic kidney disease. For clinical decision–making, it is important to know whether discontinuation of lithium can lead to improvement of renal function. We studied the trajectory of renal function in a population previously on chronic lithium therapy. Methods From a large database of patients on chronic lithium therapy, we selected a group of patients who stopped using lithium and whose creatinine values at least half a year after lithium withdrawal were available. We measured the slope of renal function (eGFR) before and after discontinuation of lithium. We compared the subgroup of patients with improvement of the renal function with those who showed further deterioration of the eGFR. Results eGFR slope significantly improved after discontinuation of lithium. Of patients with chronic kidney disease stage 3 or more (eGFR<60 ml/min), the vast majority showed an increase of eGFR or a decrease in the rate of decline after lithium withdrawal. The group of patients with further deterioration of the renal function had a mean eGFR of 32 ml/min, which was significantly lower than the patients with an improvement of the kidney function. Conclusions Discontinuation of lithium leads in the majority of patients to improvement in renal function or at least less rapid deterioration.