Long-Term Lithium Treatment and Renal Functions

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Abstract
Renal functions were examined in 53 patients before the start of long-term Li treatment (I) and then after 4 mo. (II) and 12 mo. (III) on Li treatment. The tubular function was studied by means of the DDAVP [1-desamino-8-D-arginine vasopressin] (Minirin) test and the glomerular filtration rate was measured by creatinine clearance. The mean maximum urine osmolality (.+-. SE) on the 1st occasion (I) was 800 .+-. 20 mosm/kg H2O, 702 .+-. 20 on the 2nd (II), and on the 3rd (III) 723 .+-. 17 mosm/kg H2O. The mean creatinine clearance before the start of Li treatment (I) was 128 .+-. 5 ml/min, after 4 mo. (II) 106 .+-. 4 and after 12 mo. (III) 114 .+-. 5 ml/min. Evidently, Li treatment with serum levels .apprx. 0.6 mmol/l causes a decrease in renal concentrating ability and the glomerular filtration rate in the early stages after the start of therapy. This decrease in the renal functions does not seem to progress during the 1st yr of Li treatment.