Kate Corrigan, Darragh Larkin, Margaret Gallagher, Allys Guerandel
{"title":"Managing bipolar affective disorder in chronic kidney disease when lithium is no longer an option.","authors":"Kate Corrigan, Darragh Larkin, Margaret Gallagher, Allys Guerandel","doi":"10.1136/bcr-2024-262898","DOIUrl":null,"url":null,"abstract":"<p><p>The therapeutic benefits of lithium use in bipolar affective disorder (BPAD) are well established; however, it can cause adverse side effects including chronic kidney disease and progression to end-stage renal disease (ESRD). We describe the cases of two patients with BPAD stable on lithium for many years. In both cases, kidney function declined towards ESRD, prompting cessation of lithium therapy and precipitating a period of mental instability. Concurrent lithium and haemodialysis treatment was successfully trialled in case 2. There is a dearth of guidance on managing those on lithium therapy with kidney disease progressing towards ESRD. We describe the management and outcomes of two such patients attending a community mental health team.</p>","PeriodicalId":9080,"journal":{"name":"BMJ Case Reports","volume":"18 5","pages":""},"PeriodicalIF":0.6000,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083063/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/bcr-2024-262898","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
The therapeutic benefits of lithium use in bipolar affective disorder (BPAD) are well established; however, it can cause adverse side effects including chronic kidney disease and progression to end-stage renal disease (ESRD). We describe the cases of two patients with BPAD stable on lithium for many years. In both cases, kidney function declined towards ESRD, prompting cessation of lithium therapy and precipitating a period of mental instability. Concurrent lithium and haemodialysis treatment was successfully trialled in case 2. There is a dearth of guidance on managing those on lithium therapy with kidney disease progressing towards ESRD. We describe the management and outcomes of two such patients attending a community mental health team.
期刊介绍:
BMJ Case Reports is an important educational resource offering a high volume of cases in all disciplines so that healthcare professionals, researchers and others can easily find clinically important information on common and rare conditions. All articles are peer reviewed and copy edited before publication. BMJ Case Reports is not an edition or supplement of the BMJ.