Evidence map›Paper›PMID 42034872›Full record

ArticleInternational journal of bipolar disorders2026

Lithium effects on renal functioning: an expert opinion and management algorithm.

Charlotte Strandhave, Hans August Stengaard Hansen, Martin Alda, Michael Bauer, Michael Berk, Pichit Buspavanich, Lasse Brandt, Andre F Carvalho, Anne Duffy, Orestes Forlenza and 32 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of bipolar disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

42 authors.

Charlotte StrandhaveDepartment of Nephrology, Aalborg University Hospital, Aalborg, Denmark.
Hans August Stengaard HansenDepartment of Nephrology, Aalborg University Hospital, Aalborg, Denmark.
Martin AldaDepartment of Psychiatry, Dalhousie University, Halifax, NS, Canada.
Michael BauerDepartment of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany.
Michael BerkIMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, Australia.
Pichit BuspavanichCharité Center for Prevention, Health and Human Sciences, Research Unit Gender in Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Lasse BrandtDepartment of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Andre F CarvalhoIMPACT (Innovation in Mental and Physical Health and Clinical Treatment) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia.
Anne DuffyDepartment of Psychiatry, Queen's University, Kingston, Ontario, Canada.
Orestes ForlenzaDepartment and Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, São Paulo, Brazil.
Mathilde Frahm LaursenDepartment of Psychiatry, Aalborg University Hospital, Moelleparkvej 10, 9000, Aalborg, Denmark.
Mark FryeDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
Michael GitlinGeffen School of Medicine at UCLA, Los Angeles, CA, USA.
Fabiano Alves GomesDepartment of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Ana Gonzalez-PintoBIOARABA. Department of Psychiatry, Hospital Universitario de Alava. University of the Basque Country. CIBERSAM, Vitoria-Gasteiz, Spain.
Paul GrofUniversity of Toronto, Toronto, ON, Canada.
Tomas HajekDepartment of Psychiatry, Dalhousie University, Halifax, NS, Canada.
Sanne V HovgesenDepartment of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Lars Vedel KessingPsychiatric Center Copenhagen, Capital Region of Denmark, Copenhagen, Denmark.
Ralph KupkaBipolar Disorders, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Ute LewitzkaDepartment of Psychiatry, Psychosomatic Und Psychotherapy, Universitätsklinikum Frankfurt - Goethe Universität, Frankfurt Am Main, Germany.
Rasmus W LichtDepartment of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Rodrigo Machado-VieiraFaillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Gin S MalhiAcademic Department of Psychiatry, Northern Clinical School, Faculty of Medicine and Health, Kolling Institute, The University of Sydney, Sydney, NSW, Australia.
Mirko ManchiaSection of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Robert M PostBipolar Collaborative Network, Chevy Chase, MD, USA.
Andrea MurruBipolar and Depressive Disorders Unit, IDIBAPS CIBERSAM, Hospital Clinic Barcelona, Barcelona, Spain.
Andrew A NierenbergDauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, USA.
Eline RegeerAltrecht, Institute for Mental Health Care, Utrecht University, Utrecht, The Netherlands.
Eva ReininghausDivision of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria.
Phillip RitterDepartment of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany.
Janusz RybakowskiDepartment of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
Balwinder SinghDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
Gabriele SaniDepartment of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Christian SimhandlBipolar Center Wiener Neustadt, Sigmund Freud University Medical Department Vienna, Wiener Neustadt, Austria.
Rebecca StrawbridgeDepartment of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Trisha SuppesDepartment of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Mauricio TohenUniversity of New Mexico, Albuquerque, NM, USA.
Leonardo TondoLucio Bini Mood Disorders Centers, Cagliari and Rome, Italy.
Eduard VietaInstitute of Neuroscience, University of Barcelona, Hospital Clinic, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
Allan H YoungDepartment of Brain Sciences, Imperial College London, London, UK.
René Ernst NielsenDepartment of Clinical Medicine, Aalborg University, Aalborg, Denmark. ren@rn.dk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis expert opinion paper addresses the critical balance between lithium’s therapeutic efficacy in recurrent mood disorders and its potential renal side effects. The objective is to provide evidence-based guidelines to enhance clinical decision-making, prevent emergence of, and mitigate risks associated with lithium-induced renal impairment.

methodsAn extensive review of epidemiological, observational, and experimental studies on lithium-induced renal impairment, focusing on its pathophysiology, clinical manifestations, and risk factors was conducted. Expert consensus and recent data were integrated to develop a management algorithm for renal monitoring and intervention.

resultsLithium remains the gold standard for mood stabilization in bipolar disorders, with robust evidence supporting its role in recurrence prevention and suicide risk reduction. While mild to moderate renal impairment is recognized as a risk factor, newer studies show a lower incidence of severe outcomes, such as end-stage kidney disease, necessitating dialysis treatment and renal transplantation, especially with appropriate monitoring, as compared to older studies. This paper addresses pathophysiological mechanisms, including arginine vasopressin resistance and chronic interstitial nephritis, alongside risk factors like rapid initial decline in glomerular filtration rate, early age at treatment initiation, cumulative dosage, mean serum levels of lithium and episodes of lithium intoxication. Effective management strategies, including judicious dosing, routine monitoring, and early nephrology referral, can significantly improve outcomes.

conclusionsLithium remains an invaluable treatment for recurrent mood disorders, and its benefits often outweigh the risks when managed appropriately. This paper provides a practical framework for clinicians to address renal concerns, emphasizing the importance of systematic monitoring and individualized care. The paper underscores the need for continued research and education of clinicians and patients to optimize lithium use while safeguarding patient health.

Indexed as

Arginine vasopressin resistanceBipolar disorderChronic kidney diseaseLithiumNephrotoxicityRenal impairment

Identifiers

PMID42034872
PMCPMC13253906

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.