Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-19T10:34:57.621Z Has data issue: false hasContentIssue false
  • English
  • Français

Un estudio de cohorte histórica del daño renal en pacientes con litio a largo plazo: necesidad de vigilancia continuada

Published online by Cambridge University Press:  12 May 2020

H. Bendz ,
M. Aurell  and
J. Lanke
H. Bendz
Affiliation:
Departamento de Neurociencia Clínica, Sección de Psiquiatría, Universidad de Lund, Suecia
M. Aurell
Affiliation:
Departamento de Nefrología, Universidad de Gotemburgo, Gotemburgo, Suecia
J. Lanke
Affiliation:
Departamento de Estadística, Universidad de Lund, Lund, Suecia
Get access

Resumen

Antecedentes.

La insuficiencia de los conocimientos sobre el destino longitudinal de la función renal en los pacientes con litio dio pie a este estudio retrospectivo de 149 pacientes.

Método.

Revisión de las historias clínicas de una cohorte con litio (N = 149), 8-12 afios después de un estudio ini-cial de la función renal.

Resultados.

Veintiún pacientes habían muerto, uno de uremia no causada proba-blemente por el litio, y 42 habían dejado de tomar esta sustancia. La reducción de la capacidad de concentración urinaria (Umax) o la tasa de filtración glomerular (TFG) no era más frecuente entre los pacientes fallecidos o los que habían dejado de tomar el litio que entre los 86 pacientes que estaban con litio en el seguimiento. La Umax se había examinado de nuevo en 63 de estos últimos pacientes después del estudio inicial y la TFG, en 29. La reducción de la Umax y la TFG había doblado su frecuencia, y la Umax y la TFG medias se habían reducido significativamente. La reducción de la TFG se asociaba con la duración del tratamiento de litio y la edad, y la reducción de la Umax, sólo con la duración del tratamiento.

Conclusiones.

La reducción de la función renal no es una causa importante de interrupción del tratamiento, pero se hace cada vez frecuente con la duración del tratamiento.

Limitaciones.

Los datos que fal-taban dificultaron la interpretación en algunos aspectos.

Pertinencia clínica.

El aumento de la proporción de pacientes con reducción de la TFG y la Umax con el tiempo implica un mayor riesgo de deshidrata-ción potencialmente letal e intoxicación por litio. Por tanto, es necesaria la vigilancia continuada de la diuresis y la TFG.

Keywords

litioestudio longitudinalnefropatíafunción renalefectos secundarios
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 8 , Issue 7 , October 2001 , pp. 452 - 460
Copyright
Copyright © European Psychiatric Association 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bibliografía

Anonymous. Dáligt Kand litiumbiverkan vid operation orsakade kvinnas dód (Poorly known side-effect of lithium caused a woman’s death). Lakartidningen 1996; 92: 3924.Google Scholar
Aurell, MSvalander, CWallin, LAlling, C.Renal function and biopsy findings in patients on long-term lithium-treatment. Kidney Int 1981; 20: 663–670.CrossRefGoogle ScholarPubMed
Azam, HNewton, RWMorris, ADThompson, CJ.Hyperosmolar nonketotic coma precipitated by lithium-induced nephrogenic diabetes insipidus. Postgrad Med J 1998; 74: 39–46.CrossRefGoogle ScholarPubMed
Benz, HAndersch, SAurell, M.Kidney function in an unselected lithium population. A cross-sectional study. Acta Psychiatr Scand 1983; 68: 303–334.Google Scholar
Bendz, H.Kidney function in lithium-treated patients. A literature survey. Acta Psychiatr Scand 1983; 68: 325–334.CrossRefGoogle ScholarPubMed
Bendz, HAndersch, SAurell, M.Kidney function in a selected lithium population. A prospective, controlled, lithium withdrawal study. Acta Psychiatr Scand 1985; 72: 451–463.CrossRefGoogle Scholar
Bendz, H.A case of solute diuresis erroneously diagnosed as lithium-induced diabetes insipidus. Acta Psychiatr Scand 1985; 71: 92–3.CrossRefGoogle Scholar
Bendz, HAurell, MBalldin, JSjódin, I.Kidney damage in long-term lithium patients. A cross-sectional study of patients with 15 years or more in lithium. Nephrol Dial Transplant 1994; 9: 1250–1254.Google ScholarPubMed
Bendz, HSjódin, IAurell, M.Renal function on and off lithium in patients treated with litium for 15 years or more. A controlled, pospective lithium-withdrawal study. Nephrol Dial Transplant 1996; 11: 457–460.CrossRefGoogle Scholar
Bendz, HSjódin, IToss, GBerglund, K.Hyperparathyroidism and long-term lithium therapy -a cross-sectional study and the effect of lithium withdrawal. J Int Med 1996; 240: 357–365.CrossRefGoogle ScholarPubMed
Boton, RGaviria, MBatle, DC.Prevalence, pathogenesis, and treatment of renal dysfunction associated with chronic lithium therapy. Am J Kidney Dis 1987; 10: 329–345.CrossRefGoogle ScholarPubMed
Bróchner-Mortensen, J.A simple method for the determination of glomerular filtration rate. Scand J Clin Lab Invest 1972; 30: 271–274.CrossRefGoogle ScholarPubMed
Bucht, GWahlin, A.Renal concentrating capacity in long-term lithium treatment and after withdrawal of lithium. Acta Med Scand 1980; 207: 309–314.CrossRefGoogle ScholarPubMed
Cuesta, MJPerez-Nievas, FHernández, RLanzas, GPeralta, V.Neuroleptic malignant syndrome folowing a lithium-induced nephrogenic diabetes insipidus. Eur Psychiatry 1996; 11: 325–326.CrossRefGoogle Scholar
Daisley, HBarton, ENWilliams, CT.Fatal lithium toxicity during a religious fast. South Med J 1990; 83: 364.CrossRefGoogle ScholarPubMed
Delin, KAurell, M, Ewald J. Urinary concentration test with desmopressin. Br Med J 1978; 1: 757–758.CrossRefGoogle ScholarPubMed
de Paulo, JR JrCohén, MJCorrea, ElSapir, DG.Letter to the editor. Am J Pschiatry 1987; 144: 823.Google Scholar
Gitlin, MJ.Lithium-induced renal insufficiency. J Clin Pharmacology 1993; 13: 276–9.Google ScholarPubMed
Gitlin, MJ.Lithium and the kidney. An updated review. Drug Safety 1999; 20: 231–243.CrossRefGoogle ScholarPubMed
Gray, EJDierks, EJ.Lithium-induced diabetes insipidus in a surgical patients: report of a case and review of the literature. J Oral Maxillofac Surg 1996; 54: 909–912.CrossRefGoogle Scholar
Granérus, GAurell, M.Reference valúes for 51Cr-EDTA clearance as a measure of glomerular filtration rate. Scand J Clin Lab Invest 1981; 41: 611–616.CrossRefGoogle ScholarPubMed
Grindlinger, GABoylan, MJ.Amelioration by indome-thazin of lithium-induced polyuria. Crit Care Med 1987; 15: 538–539.CrossRefGoogle ScholarPubMed
Hansen, HE.Lithium intoxication (Report of 23 cases and review of 100 cases from the literature). QJ Med 1978; 47: 123–144.Google Scholar
Hansen, HE.Renal toxicity of lithium. Drugs 1981; 22: 461–476.CrossRefGoogle ScholarPubMed
Hestbech, JHansen, HEAmdisen, AOlsen, S.Chronic renal lesions following long-term treatment with lithium. Kidney Int 1977; 12: 205–213.CrossRefGoogle ScholarPubMed
Hetmar, OJuul Povlsen, ULadefoged, JBolwig, T.Lithium: long-term effects on the kidney. A prospective follow-up study ten years after kidney biopsy. Br J Psychiatry 1991; 158: 53–58.CrossRefGoogle ScholarPubMed
Himmelhoch, JM.On the failure to recognize lithium failure. Psychiatr Ann 1994; 24: 241–250.CrossRefGoogle Scholar
Johnson, MAOgorman, JGolembiewski, GHPaluzzi, MW.Nephrogenic diabetes insipidus secondary to lithium therapy in the postoperative patient: a case report. Am Surg 1994; 60: 836–9.Google ScholarPubMed
MacDonald, KJLittle, PJBailey, RR.Lithium and the kidney. NZ Med J 1979; 90: 323–325.Google ScholarPubMed
MacGregor, DABaker, AMAppel, RGOber, KPZaloga, GP.Hyperosmolar coma due to lithium-induced diabetes insipidus. Lancet 1995; 346: 413–417.CrossRefGoogle Scholar
Markowitz, GSRadhakrishnan, JKambham, NValeri, AMHiñes, WHd’Agati, V.Lithium toxicity: a progressive combined glomerular and tubulointerstitial nephropathy. J Am Soc Nephrol 2000; 11: 1439–48.Google ScholarPubMed
Meinardi, JRDonders, SHJ.Nephrogenic diabetes insipidus in a lethargic lithium-treated patient. Neth J Med 1997; 50: 105–109.CrossRefGoogle Scholar
Nilsson, AAxelsson, R.Effects of long-term lithium treatment on thyroid and renal function (serum creatinine and maximal uriñe osmolality) -a prospective study in psychiatric patients. Curr Ther Res 1989; 46: 85–102.Google Scholar
Page, CBenaim, SLappin, F.A long-term retrospective follow-up study of patients treated with prophylactic lithium carbonate. Br J Psychiatry 1987; 150: 175–179.CrossRefGoogle ScholarPubMed
Schou, MVestergaard, P.Prospective studies on a lithium cohort. 2. Renal function. Water and electrolyte metabolism. Acta Psychiatr Scand 1988; 78: 427–433.CrossRefGoogle ScholarPubMed
Schou, M.Lithium treatment and kidney function. Clinical observations. In: Christensen, S, Ed. Lithium and the kidney. Base Karger; 1990. p. 143–154.Google Scholar
Thompson, CJFrance, AJBaylis, PH.Persistent nephrogenic diabetes insipidus following lithium therapy. Scott Med J 1997; 42: 16–17.CrossRefGoogle ScholarPubMed
Tryding, NBerg, BEkman, SNilsson, JESterner, GHarris, A.DDAVP test for renal concentration capacity. Age-related reference intervals. Scand J Urol Nephrol 1988; 22: 141–145.CrossRefGoogle ScholarPubMed