Lithium use - A Friend or Foe to kidney health ?

In this retrospective cohort study, the researchers included 2310 patients who were treated with lithium in Iceland between 2003–2018. They were compared with a control group patients with affective disorders (ICD 10 codes F30-F39) attending the outpatient clinic of the Mental Health Services at Landspitali–the National University Hospital in 2014–2016, who had never used lithium. The researchers obtained clinical and laboratory data, including ICD-9 and ICD-10 codes and serum creatinine (SCr) values from nationwide electronic medical records. They determined AKI using the SCr component of the KDIGO criteria and used multivariable logistic regression for the analysis.

Key findings of the study:

• Among 2310 patients in the lithium group, the researchers noted that 297 developed AKI.
• Among 1426 individuals in the control group, 1218 (85.5%) were included and, 97 (8.0%) developed AKI.
• Upon analysis, the researchers noted that lithium use was not an independent risk factor for AKI (OR 0.93).
• When lithium users were analyzed separately, they found that the lithium intoxication (OR 2.34), duration of lithium therapy (OR 1.01) and mean lithium concentration (OR 1.22) were all significant risk factors for the development of AKI.

The authors concluded, "Our findings suggest that lithium use does not affect the incidence of AKI after controlling for important covariates. However, lithium intoxication, time on lithium therapy and blood lithium concentration are associated with increased risk of AKI."

For further information: Gisli Gislason et al., Incidence of AKI in Individuals Treated with Lithium, American Society of Nephrology, Abstract: PO0188.