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Højlund M, Winkel JS, Nybo M, Hallas J, Henriksen DP, Damkier P. Lithium and the risk of chronic kidney disease: A population-based case-control study. Basic Clin Pharmacol Toxicol 2022; 131:129-137. [PMID: 35644911 PMCID: PMC9541887 DOI: 10.1111/bcpt.13758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/21/2022] [Accepted: 05/24/2022] [Indexed: 11/26/2022]
Abstract
The association between lithium use and chronic kidney disease (CKD) needs further evaluation. We aimed to investigate this association using Danish nationwide healthcare registers and routinely collected plasma creatinine measurements from the Funen Laboratory Cohort. We conducted a case–control study nested within the population of Funen, 2001–2015. Incident cases of CKD (estimated glomerular filtration rate <60 ml/min/1.73m2; n = 21 432) were matched with four CKD‐free controls on age, sex and calendar time (n = 85 532). We estimated odds ratios (OR) for the association between lithium exposure and CKD using conditional logistic regression models, adjusted for known risk factors for CKD. Ever‐use of lithium was associated with an increased risk of CKD (adjusted OR [aOR]: 1.57; 95% confidence interval [CI]: 1.33–1.85). A stronger association was seen with current use of lithium (aOR: 1.92; 95%CI: 1.58–2.33) and long‐term use of lithium (>10 years: aOR: 3.02; 95%CI: 2.00–4.56). Furthermore, we found evidence of a dose–response relationship between cumulative dose of lithium and the risk of CKD. In conclusion, the use of lithium, especially long‐term, is associated with an increased risk of CKD, although the extent to which detection bias and confounding by indication contribute to the association is unclear. Monitoring of kidney function in lithium users remains mandatory to identify individuals in which switching to alternative medications should be considered.
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Affiliation(s)
- Mikkel Højlund
- Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.,Department of Psychiatry Aabenraa, Mental Health Services in the Region of Southern Denmark, Aabenraa, Denmark
| | | | - Mads Nybo
- Department of Clinical Biochemistry, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jesper Hallas
- Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.,Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark
| | - Daniel Pilsgaard Henriksen
- Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.,Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark
| | - Per Damkier
- Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.,Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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