ArticleNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology2016
Stratifying Risk for Renal Insufficiency Among Lithium-Treated Patients: An Electronic Health Record Study.
Article in Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- Psychotropic Drugs and Adverse Kidney Effects: A Systematic Review of the Past Decade of Research.CNS drugs · 2022Pooled it
- Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder.Bipolar disorders · 2018Guideline
- Lithium effects on renal functioning: an expert opinion and management algorithm.International journal of bipolar disorders · 2026Article
- Rare loss-of-function variants in HECTD2 and AKAP11 confer risk of bipolar disorder.Nature genetics · 2025Article
- Lithium for Bipolar Disorder and Risk of Thyroid Dysfunction and Chronic Kidney Disease.JAMA network open · 2025Article
- Coding for Physical Restraint Status Among Hospitalized Patients: a 2019 National Inpatient Sample Analysis.Journal of general internal medicine · 2023Article
- The low risk for early renal damage during lithium treatment has not changed over time.Journal of psychopharmacology (Oxford, England) · 2023Article
- Real-world evidence of age-independent electroconvulsive therapy efficacy: A retrospective cohort study.Acta psychiatrica Scandinavica · 2022Article
- Artificial Intelligence for Mental Health Care: Clinical Applications, Barriers, Facilitators, and Artificial Wisdom.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2021Review
- Determinants of Kidney Function and Accuracy of Kidney Microcysts Detection in Patients Treated With Lithium Salts for Bipolar Disorder.Frontiers in pharmacology · 2021Article
- Assessment of kidney health and exposure to mixture pollutants in the Mexican indigenous population.Environmental science and pollution research international · 2020Article
- Diagnostic tests and treatment procedures performed prior to cardiovascular death in individuals with severe mental illness.Acta psychiatrica Scandinavica · 2020Article
- Increased synapse elimination by microglia in schizophrenia patient-derived models of synaptic pruning.Nature neuroscience · 2019Article
- Factors related to lithium blood concentrations in Chinese Han patients with bipolar disorder.Neuropsychiatric disease and treatment · 2019Article
- Lithium and nephrotoxicity: a literature review of approaches to clinical management and risk stratification.BMC nephrology · 2018Review
- The use of electronic health records for psychiatric phenotyping and genomics.American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics · 2018Review
- Long-term lithium treatment in bipolar disorder: effects on glomerular filtration rate and other metabolic parameters.International journal of bipolar disorders · 2017Article
- Big data for bipolar disorder.International journal of bipolar disorders · 2016Review
- Abandoning personalization to get to precision in the pharmacotherapy of depression.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2016Article
- Identifying a clinical signature of suicidality among patients with mood disorders: A pilot study using a machine learning approach.Journal of affective disorders · 2016Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
Although lithium preparations remain first-line treatment for bipolar disorder, risk for development of renal insufficiency may discourage their use. Estimating such risk could allow more informed decisions and facilitate development of prevention strategies. We utilized electronic health records from a large New England health-care system between 2006 and 2013 to identify patients aged 18 years or older with a lithium prescription. Renal insufficiency was identified using the presence of renal failure by ICD9 code or laboratory-confirmed glomerular filtration rate below 60 ml/min. Logistic regression was used to build a predictive model in a random two-thirds of the cohort, which was tested in the remaining one-third. Risks associated with aspects of pharmacotherapy were also examined in the full cohort. We identified 1445 adult lithium-treated patients with renal insufficiency, matched by risk set sampling 1 : 3 with 4306 lithium-exposed patients without renal insufficiency. In regression models, features associated with risk included older age, female sex, history of smoking, history of hypertension, overall burden of medical comorbidity, and diagnosis of schizophrenia or schizoaffective disorder (p<0.01 for all contrasts). The model yielded an area under the ROC curve exceeding 0.81 in an independent testing set, with 74% of renal insufficiency cases among the top two risk quintiles. Use of lithium more than once daily, lithium levels greater than 0.6 mEq/l, and use of first-generation antipsychotics were independently associated with risk. These results suggest the possibility of stratifying risk for renal failure among lithium-treated patients. Once-daily lithium dosing and maintaining lower lithium levels where possible may represent strategies for reducing risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.