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Renal Failure in Lithium-Treated Bipolar Disorder: A Retrospective Cohort Study

Close, H.; Reilly, J.; Mason, J.M.; Mukesh, K.; Wilson, D.; Main, J.; Hungin, A.P.S.

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Authors

H. Close

J. Reilly

J.M. Mason

K. Mukesh

D. Wilson

J. Main

A.P.S. Hungin



Abstract

Objective: Lithium users are offered routine renal monitoring but few studies have quantified the risk to renal health. The aim of this study was to assess the association between use of lithium carbonate and incidence of renal failure in patients with bipolar disorder. Methods: This was a retrospective cohort study using the General Practice Research Database (GPRD) and a nested validation study of lithium exposure and renal failure. A cohort of 6360 participants aged over 18 years had a first recorded diagnosis of bipolar disorder between January 1, 1990 and December 31, 2007. Data were examined from electronic primary care records from 418 general practices across the UK. The primary outcome was the hazard ratio for renal failure in participants exposed to lithium carbonate as compared with non-users of lithium, adjusting for age, gender, co-morbidities, and poly-pharmacy. Results: Ever use of lithium was associated with a hazard ratio for renal failure of 2.5 (95% confidence interval 1.6 to 4.0) adjusted for known renal risk factors. Absolute risk was age dependent, with patients of 50 years or older at particular risk of renal failure: Number Needed to Harm (NNH) was 44 (21 to 150). Conclusions: Lithium is associated with an increased risk of renal failure, particularly among the older age group. The absolute risk of renal failure associated with lithium use remains small.

Citation

Close, H., Reilly, J., Mason, J., Mukesh, K., Wilson, D., Main, J., & Hungin, A. (2014). Renal Failure in Lithium-Treated Bipolar Disorder: A Retrospective Cohort Study. PLoS ONE, 9(3), Article e90169. https://doi.org/10.1371/journal.pone.0090169

Journal Article Type Article
Publication Date Mar 26, 2014
Deposit Date Jan 29, 2014
Publicly Available Date Aug 21, 2014
Journal PLoS ONE
Electronic ISSN 1932-6203
Publisher Public Library of Science
Peer Reviewed Peer Reviewed
Volume 9
Issue 3
Article Number e90169
DOI https://doi.org/10.1371/journal.pone.0090169
Public URL https://durham-repository.worktribe.com/output/1472046

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Publisher Licence URL
http://creativecommons.org/licenses/by/4.0/

Copyright Statement
© 2014 Close et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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