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Abstract: PO2284

Incidence of CKD Stages 3-5 Among Patients on Lithium Therapy

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Gislason, Gisli, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
  • Indridason, Olafur S., Division of Nephrology, Landspitali - the National University Hospital of Iceland, Reykjavik, Iceland
  • Sigurdsson, Engilbert, Mental Health Services, Landspitali - the National University Hospital of Iceland, Reykjavik, Iceland
  • Palsson, Runolfur, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
Background

The association between lithium use and chronic kidney disease (CKD) is not well understood, and the impact of comorbidities and other factors remains unknown. The aim of this study was to examine the risk of developing CKD stage 3 and above among individuals using lithium.

Methods

This was a retrospective cohort study of all patients in Iceland treated with lithium in the years 2008-2018. A control group was comprised of patients with affective disorders (ICD-10 codes F30-F39) who attended the outpatient clinics of the Landspitali–The National University Hospital Mental Health Services in 2014-2016 and had not been prescribed lithium. CKD stages 3-5 was defined according to the KDIGO 2012 guidelines and eGFR was calculated from serum creatinine (SCr) using the CKD-EPI equation. Individuals with CKD 3-5 prior to 2008 and those with fewer than 2 SCr measurements during the study period were excluded. Risk assessment was performed using logistic regression.

Results

A total of 2682 persons had received lithium treatment, of whom 2051 (76.5%) were included in the study. Of those 221 (10.8%) developed CKD 3-5. Of the 1426 persons in the control group, 1010 (70.8%) were included, of whom 29 (2.9%) developed CKD 3-5. Lithium use was significantly associated with CKD development (OR 1.94, 95% CI 1.25–3115) after adjusting for sex, age and comorbid diseases (Table).

Conclusion

Lithium treatment is a highly significant independent risk factor for the development of CKD in individuals with affective disorders.

Factors associated with CKD, multivariable logistic regression.
 Odds Ratio95% confidence interval
Sex, men0.870.63 - 1.19
Age1.031.02 - 1.04
Initial eGFR0.930.92 - 0.94
Hypertensioon1.200.81 - 1.77
Diabetes1.781.05 - 2.94
Acute kidney injury1.681.12 - 2.50
Lithium use1.941.25 - 3.11

Funding

  • Government Support – Non-U.S.