Long-term lithium treatment in bipolar disorder: effects on glomerular filtration rate and other metabolic parameters

International Journal of Bipolar Disorders

Table 4 Factors associated with vs. without low eGFR among 312 bipolar disorder subjects treated long-term with lithium

Factor	Low eGFR^a	Normal eGFR	p-value [χ ² or t-score]
Subjects	92	220	–
Sex (%)			0.003 [8.98]
Women	36.1	63.9
Men	20.5	79.5
Ages (years)
Illness onset	31.8 [29.4–34.2]	27.1 [25.7–28.5]	0.0007 [3.41]
Started lithium	42.5 [39.8–45.2]	35.9 [34.2–37.6]	<0.0001 [4.19]
Final lithium	65.0 [62.4–67.6]	52.0 [50.3–53.7]	<0.0001 [8.09]
Co-treatments (%)
Anticonvulsants	23.7	45.5	0.001 [10.4]
Antipsychotics	47.4	64.6	0.01 [6.40]
Antidepressants	25.0	36.1	0.07 [3.25]
Initial eGFR	77.2 ± 16.1	94.6 ± 21.9	<0.0001 [6.74]

Means are with 95% CI. Serum lithium concentration is in mEq/L; dose is of lithium carbonate is total mg/day. Additional factors not associated with low eGFR: (1) diagnosis (bipolar I vs. bipolar II), (2) education, (3) metabolic syndrome (overall risk = 30.4%), (4) any substance abuse, (5) alcohol abuse, (6) smoking, (7) any suicidal act, (8) serum TSH. Medical illnesses include cardiovascular and metabolic syndromes
^aLow eGFR: subjects with at least one value <60 mL/min/1.73 m²; the observed rate of such subjects was 92/312 (29.5%), but 312/2669 assays (11.3%)