Lithium use in a patient on haemodialysis with bipolar affective disorder and lithium-induced nephropathy.
BMJ Case Rep
; 14(7)2021 Jul 30.
Article
en En
| MEDLINE
| ID: mdl-34330723
ABSTRACT
Lithium is an effective mood stabiliser used to treat bipolar affective disorder (BPAD); however, it can also adversely affect the kidneys, causing acute toxic effects, nephrogenic diabetes insipidus, chronic renal dysfunction and end-stage kidney disease (ESKD) in a minority of patients. We describe the case of a man with a 34-year history of BPAD type-1 and a 2-year history of ESKD secondary to lithium-induced nephropathy who experienced a manic relapse. He previously responded well to lithium but, following a deterioration in kidney function, was switched to olanzapine and sodium valproate. This precipitated a period of instability, which culminated in a treatment-resistant manic episode requiring hospital admission. After a multidisciplinary team discussion, lithium therapy was restarted and provided remission. This was achieved safely through a reduced dosing schedule of three times a week post dialysis, slow dose titration and blood level monitoring prior to each dialysis session.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Antipsicóticos
/
Trastorno Bipolar
/
Enfermedades Renales
Límite:
Humans
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Male
Idioma:
En
Revista:
BMJ Case Rep
Año:
2021
Tipo del documento:
Article
País de afiliación:
Reino Unido