Corrigan Kate, Larkin Darragh, Gallagher Margaret, Guerandel Allys
Kildare/West Wicklow Mental Health Services, Naas General Hospital, Kildare, Ireland
St Vincent's University Hospital, Dublin, Ireland.
BMJ Case Rep. 2025 May 14;18(5):e262898. doi: 10.1136/bcr-2024-262898.
The therapeutic benefits of lithium use in bipolar affective disorder (BPAD) are well established; however, it can cause adverse side effects including chronic kidney disease and progression to end-stage renal disease (ESRD). We describe the cases of two patients with BPAD stable on lithium for many years. In both cases, kidney function declined towards ESRD, prompting cessation of lithium therapy and precipitating a period of mental instability. Concurrent lithium and haemodialysis treatment was successfully trialled in case 2. There is a dearth of guidance on managing those on lithium therapy with kidney disease progressing towards ESRD. We describe the management and outcomes of two such patients attending a community mental health team.
锂用于双相情感障碍（BPAD）的治疗益处已得到充分证实；然而，它可能会引起不良副作用，包括慢性肾病以及进展至终末期肾病（ESRD）。我们描述了两名多年来一直稳定服用锂剂的BPAD患者的病例。在这两个病例中，肾功能均朝着ESRD方向下降，促使停用锂剂治疗，并引发了一段时间的精神不稳定。在病例2中成功尝试了锂剂与血液透析的联合治疗。对于那些肾病进展至ESRD的锂剂治疗患者，缺乏管理方面的指导。我们描述了两名在社区精神卫生团队就诊的此类患者的管理情况及结果。
