Faculty of Medicine, Department of Psychiatry, Hacettepe University, Ankara, Turkey.
Faculty of Medicine, Department of Biostatistics, Hacettepe University, Ankara, Turkey.
Hum Psychopharmacol. 2022 Mar;37(2):e2812. doi: 10.1002/hup.2812. Epub 2021 Sep 20.
The aim of this study was to investigate the effect of lithium treatment on renal function and to determine influencing factors. In addition, the utility of spot urine protein/creatinine ratio in detection of lithium induced nephropathy was also investigated.
Serum concentrations of lithium, blood urea nitrogen (BUN), creatinine, estimated glomerular filtration rate (eGFR), and urinalysis including protein/creatinine ratio were measured in 375 patients using lithium.
Patients taking lithium for ≥8 years had higher BUN, creatinine levels, percentage of proteinuria, percentages of stage 2 and 3 chronic kidney disease (CKD); lower urine density and eGFR compared to patients taking lithium <8 years. Urine density was lower in groups with >0.8 and 0.6-0.8 mmol/L lithium level than <0.6 mmol/L. Predictors of CKD were serum level of lithium, dose of lithium, cumulative duration of lithium use, age at onset of illness, and caffeine consumption.
Detrimental effects of lithium on renal functions were detected after lithium use for ≥8 years. Proteinuria measured by spot urine protein/creatinine ratio can be detected even when eGFR is >90 ml/min/1.73 m . Spot urine protein/creatinine ratio, which is a cost-effective and practical laboratory test, can be used to monitor lithium-treated patients.
本研究旨在探讨锂治疗对肾功能的影响，并确定影响因素。此外，还研究了尿蛋白/肌酐比值在检测锂诱导肾病中的应用。
对 375 例锂治疗患者进行血清锂浓度、血尿素氮（BUN）、肌酐、估计肾小球滤过率（eGFR）和尿液分析，包括蛋白/肌酐比值。
锂治疗≥8 年的患者的 BUN、肌酐水平、蛋白尿百分比、2 期和 3 期慢性肾脏病（CKD）的百分比均高于锂治疗<8 年的患者；尿密度和 eGFR 较低。锂水平>0.8 和 0.6-0.8 mmol/L 组的尿密度低于<0.6 mmol/L 组。锂的血清水平、锂剂量、锂使用累积时间、发病年龄和咖啡因摄入是 CKD 的预测因素。
锂治疗≥8 年后检测到锂对肾功能的有害影响。即使 eGFR>90 ml/min/1.73 m ，也可以通过检测尿蛋白/肌酐比值来检测蛋白尿。尿蛋白/肌酐比值是一种经济实用的实验室检测方法，可用于监测锂治疗患者。
