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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
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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

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