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管理锂诱导肾病的风险在反复发作的情感障碍患者的长期治疗中。

Managing the risk of lithium-induced nephropathy in the long-term treatment of patients with recurrent affective disorders.

机构信息

Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr, 74, D-01307 Dresden, Germany.

出版信息

BMC Med. 2013 Feb 11;11:34. doi: 10.1186/1741-7015-11-34.

Abstract

Lithium has been the most effective psychopharmacological drug in the long-term treatment of patients with recurrent unipolar and bipolar affective illness. As a result of its widespread and longtime use in patients with recurrent affective disorders, psychiatrists have become increasingly aware of the whole spectrum of lithium's potential side effects. One of the side effects associated with its chronic use is lithium-induced nephropathy. In a recent cross-sectional study published in BMC Medicine, Alberto Bocchetta et al. add further information to this topic, demonstrating that duration of lithium treatment is associated with impaired glomerular function in patients with recurrent or chronic affective disorders. The present paper will discuss the implications of this and other related recent research on our management of patients with recurrent affective disorders. In this context the importance of shared decision making and close monitoring of kidney function is highlighted, including the regular assessment of the glomerular filtration rate, to provide best possible care to our patients maintained on lithium treatment.See related research article here http://www.biomedcentral.com/1741-7015/11/33.

摘要

锂一直是治疗复发性单相和双相情感障碍患者的最有效精神药理学药物。由于其在复发性情感障碍患者中的广泛和长期使用,精神科医生越来越意识到锂的所有潜在副作用。与慢性使用相关的副作用之一是锂诱导的肾病。在最近发表在《BMC 医学》上的一项横断面研究中,Alberto Bocchetta 等人为此主题提供了更多信息,表明复发性或慢性情感障碍患者的锂治疗持续时间与肾小球功能受损有关。本文将讨论这一发现以及其他相关的最新研究对我们对复发性情感障碍患者的管理的影响。在这种情况下,突出强调了共同决策和密切监测肾功能的重要性,包括定期评估肾小球滤过率,为接受锂治疗的患者提供尽可能好的护理。在此处查看相关研究文章:http://www.biomedcentral.com/1741-7015/11/33。

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本文引用的文献

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Lithium toxicity profile: a systematic review and meta-analysis.锂中毒的表现:系统评价和荟萃分析。
Lancet. 2012 Feb 25;379(9817):721-8. doi: 10.1016/S0140-6736(11)61516-X. Epub 2012 Jan 20.
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Effects of chronic lithium treatment on renal function.慢性锂治疗对肾功能的影响。
J Affect Disord. 2010 Nov;126(3):436-40. doi: 10.1016/j.jad.2010.04.018. Epub 2010 May 16.
8
Lithium nephrotoxicity revisited.再探锂的肾毒性。
Nat Rev Nephrol. 2009 May;5(5):270-6. doi: 10.1038/nrneph.2009.43.

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