Continuation of lithium after a diagnosis of chronic kidney disease.

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Bibliographic Details
Title:	Continuation of lithium after a diagnosis of chronic kidney disease.
Authors:	Kessing, L. V., Feldt‐Rasmussen, B., Andersen, P. K., Gerds, T. A., Licht, R. W.
Source:	Acta Psychiatrica Scandinavica. Dec2017, Vol. 136 Issue 6, p615-622. 8p. 2 Charts, 2 Graphs.
Subjects:	Therapeutic use of lithium, Chronic kidney failure, Anticonvulsants, Bipolar disorder, Therapeutics research
Abstract:	Objective To investigate whether continued lithium or anticonvulsant treatment after a first diagnosis of chronic kidney disease ( CKD) was associated with progression to irreversible end-stage kidney disease. Methods Nationwide cohort study including all individuals in Denmark in a period from 1995 to 2012 with a diagnosis of CKD and (i) a history of lithium treatment ( N = 754, among whom 238 patients had a diagnosis of bipolar disorder) or (ii) a history of anticonvulsant treatment ( N = 5.004, among whom 199 patients had a diagnosis of bipolar disorder). End-stage CKD was defined as chronic dialysis or renal transplantation. Results Continuing lithium ( HR = 0.58 (95% CI: 0.37-0.90) and continuing anticonvulsants ( HR = 0.53 (95% CI: 0.44-0.64) were associated with decreased rates of end-stage CKD. In the subcohorts of patients with a diagnosis of bipolar disorder, continuing lithium was associated with decreased end-stage CKD ( HR = 0.40 (95% CI: 0.17-0.98), whereas continuing anticonvulsants was not ( HR = 0.70 (95% CI: 0.21-2.37). There were no interactions of continuing lithium and anticonvulsants. Conclusion After an initial diagnosis of CKD, patients who are selected by their physicians to continue lithium treatment may not necessarily have an increased risk of developing end-stage CKD. Shifting to an anticonvulsant per se may not be associated with an advantage; however, this requires further investigation. [ABSTRACT FROM AUTHOR]
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Database:	Psychology and Behavioral Sciences Collection

Description
Abstract:	Objective To investigate whether continued lithium or anticonvulsant treatment after a first diagnosis of chronic kidney disease ( CKD) was associated with progression to irreversible end-stage kidney disease. Methods Nationwide cohort study including all individuals in Denmark in a period from 1995 to 2012 with a diagnosis of CKD and (i) a history of lithium treatment ( N = 754, among whom 238 patients had a diagnosis of bipolar disorder) or (ii) a history of anticonvulsant treatment ( N = 5.004, among whom 199 patients had a diagnosis of bipolar disorder). End-stage CKD was defined as chronic dialysis or renal transplantation. Results Continuing lithium ( HR = 0.58 (95% CI: 0.37-0.90) and continuing anticonvulsants ( HR = 0.53 (95% CI: 0.44-0.64) were associated with decreased rates of end-stage CKD. In the subcohorts of patients with a diagnosis of bipolar disorder, continuing lithium was associated with decreased end-stage CKD ( HR = 0.40 (95% CI: 0.17-0.98), whereas continuing anticonvulsants was not ( HR = 0.70 (95% CI: 0.21-2.37). There were no interactions of continuing lithium and anticonvulsants. Conclusion After an initial diagnosis of CKD, patients who are selected by their physicians to continue lithium treatment may not necessarily have an increased risk of developing end-stage CKD. Shifting to an anticonvulsant per se may not be associated with an advantage; however, this requires further investigation. [ABSTRACT FROM AUTHOR]
ISSN:	0001690X
DOI:	10.1111/acps.12820