ReviewNeuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater2025
[Lithium and its impact on renal function. Recommendations for practice, especially for older patients].
Review in Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purpose and research question of the reviewDespite its substantial therapeutic efficacy-particularly in the acute treatment and relapse prevention of bipolar affective disorders-lithium is associated with a broad spectrum of side effects, among which potential nephrotoxicity represents one of the most significant long-term risks. In clinical practice, particularly in the treatment of older adults, physicians are often faced with the question of whether lithium therapy can or should be continued, or whether initiation is feasible, given comorbid somatic illnesses, polypharmacy, or reduced glomerular filtration rate (GFR). The aim of this review is to provide practical, evidence-based recommendations for clinical decision-making.
methodsA comprehensive literature search was conducted using PubMed, Web of Science, and Google Scholar, focusing on the treatment of patients with bipolar and unipolar affective disorders with lithium and its potential effects on renal function, particularly in the context of long-term therapy and aging. A case report is included to illustrate clinical application. RESULTS AND
conclusionsLithium remains a cornerstone in the pharmacological treatment of bipolar and unipolar affective disorders, despite its known nephrotoxic potential. Optimizing the balance between therapeutic benefit and potential renal risks necessitates close monitoring and individualized treatment adjustments. The risk of lithium-induced nephropathy increases with the duration of therapy, patient age, and the frequency of episodes of lithium toxicity or overdose. Current guidelines recommend maintaining serum lithium levels within a range of 0,6-0,8 mmol/L. In older patients with good treatment response, target levels at the lower end of the therapeutic window (0,4-0,6 mmol/L) are advised. Lithium therapy should be monitored at regular intervals, including laboratory testing and 12-hour serum level checks every three months, or every 8-10 weeks in elderly patients. If GFR falls below 30 ml/min/1,73 m
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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.