Lithium usage and renal function testing in a large UK community population; a case–control study

Jo Minay, Raymond Paul, Deirdre McGarvey, Gerard Savage, Mike Stevenson, Damian Fogarty, Ciaran Mulholland, Christopher Kelly

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective
This study investigates the prevalence of lithium use, monitoring practice and associated effects on renal function in a large UK community sample.
Method
A large population-based renal function database was cross-referenced with a general practitioner database of 404,673 patients. The renal function of patients prescribed lithium during the 2-year period was compared with that of matched controls. The renal monitoring patterns of these cases were investigated in a naturalistic observational study. Data underwent parametric testing — continuous variables by analysis of variance, with appropriate adjustment, and categorical outcomes by χ2 testing. Block analysis of variance was undertaken on case–control data.
Results
A total of 422 patients in the database were prescribed lithium. Renal function monitoring in accordance with published guidelines occurred in 69% of patients. Patients taking lithium had a significantly higher serum creatinine (5.8 μmol/L, P< .001) and lower glomerular filtration rate (5.9 ml/min, P< .001) when compared to matched controls.
Conclusions
This is the first study carried out in a large community sample. Lithium remains widely prescribed in the community setting. The study confirms that lithium has a statistically and clinically significant negative effect on renal function. Despite published guidelines and recognition of the importance of serial measurements, monitoring of renal function is inconsistent.
Original languageEnglish
Pages (from-to)631-635
JournalGeneral Hospital Psychiatry
Volume35
Issue number6
Early online date13 Aug 2013
DOIs
Publication statusPublished - Nov 2013

ASJC Scopus subject areas

  • Psychiatry and Mental health

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