Lithium (Li) represents a first choice mood stabilizer for bipolar disorder (BD). Despite extensive clinical use, questions regarding its mechanism of action and pathological mechanism of renal function impairment by Li remain open. The present study aimed to improve our knowledge in this area paying special attention to the relationship between the length of Li action, lipid peroxidation (LP), and Na+/K+-ATPase properties. The effects of therapeutic Li doses, administered daily to male Wistar rats for 1 (acute), 7 (short term) and 28 days (chronic), were studied. For this purpose, Na+/K+-ATPase activity measurements, [3H]ouabain binding and immunoblot analysis of α-Na+/K+-ATPase were performed. Li-induced LP was evaluated by determining the malondialdehyde concentration by HPLC. Sleep deprivation (SD) was used as an experimental approach to model the manic phase of BD. Results obtained from the kidney were compared to those obtained from erythrocytes and different brain regions in the same tested animals. Whereas treatment with therapeutic Li concentration did not bring any LP damage nor significant changes of Na+/K+-ATPase expression and [3H]ouabain binding in the kidney, it conferred strong protection against this type of damage in the forebrain cortex. Importantly, the observed changes in erythrocytes indicated changes in forebrain cortices. Thus, different resistance to SD-induced changes of LP and Na+/K+-ATPase was detected in the kidney, erythrocytes and the brain of Li-treated rats. Our study revealed the tissue-specific protective properties of Li against LP and Na+/K+-ATPase regulation.
- MeSH
- Antimanic Agents administration & dosage pharmacology MeSH
- Bipolar Disorder drug therapy MeSH
- Time Factors MeSH
- Erythrocytes drug effects metabolism MeSH
- Rats MeSH
- Kidney drug effects metabolism MeSH
- Lithium Carbonate administration & dosage pharmacology MeSH
- Disease Models, Animal MeSH
- Brain drug effects metabolism MeSH
- Lipid Peroxidation drug effects MeSH
- Rats, Wistar MeSH
- Sodium-Potassium-Exchanging ATPase metabolism MeSH
- Sleep Deprivation psychology MeSH
- Animals MeSH
- Check Tag
- Rats MeSH
- Male MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Keywords
- sekundární nefrotický syndrom,
- MeSH
- Anti-Anxiety Agents administration & dosage therapeutic use MeSH
- Biomarkers blood urine MeSH
- Biopsy methods utilization MeSH
- Diuresis physiology drug effects MeSH
- Edema diagnosis etiology complications MeSH
- Drug Therapy MeSH
- Hyperkalemia diagnosis etiology therapy MeSH
- Humans MeSH
- Lithium Carbonate * administration & dosage adverse effects therapeutic use MeSH
- Adolescent MeSH
- Nephrology MeSH
- Nephrotic Syndrome diagnosis etiology MeSH
- Drug-Related Side Effects and Adverse Reactions etiology complications MeSH
- Proteinuria diagnosis etiology complications MeSH
- Anxiety Disorders * diagnosis drug therapy complications MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
BACKGROUND: Lithium in the form of lithium carbonate (Li2CO3) has become one of the most effective and widely prescribed drugs for mood stabilization. However, lithium has adverse effects on renal tubular functions, such as decreased concentrating function of the kidneys, and even occasional symptoms of nephrogenous diabetes insipidus occur with additional evidence of glomerular disruption in lithium-treated patients. METHODS: We assessed the kidney function of patients with bipolar disorder who are under long-term lithium treatment using novel markers of kidney damage such as plasma neutrophil gelatinase-associated lipocalin, cystatin C, albuminuria, estimated glomerular filtration rate, Chronic Kidney Disease-Epidemiology Investigation using creatinine and cystatin C, and serum and urinary osmolality, and compared the results with those of age-matched patients with bipolar disorder not treated with lithium. The study enrolled 120 patients with bipolar disorder, consisting of 80 (30 male and 50 female patients) who have been receiving lithium for 0.5 to 20 (mean, 7) years and 40 (10 male and 30 female patients) who had never been exposed to lithium treatment. RESULTS: Patients treated with lithium had significantly decreased urine osmolality (mean ± SD, 405 ± 164 vs 667 ± 174 mmol/kg) and urine-to-serum osmolality ratio (1.35 ± 0.61 vs 2.25 ± 0.96). No significant difference was found in creatinine, estimated glomerular filtration rate values calculated using the Chronic Kidney Disease-Epidemiology Investigation using creatinine and cystatin C, neutrophil gelatinase-associated lipocalin, cystatin C, and albuminuria between both groups. We found no significant difference in renal biomarkers between patients treated with lithium for 6 to 24 months and those treated for 25 to 240 months. CONCLUSIONS: We found significantly decreased kidney concentrating ability in the long-term lithium-treated patients compared with the control group. Other renal function markers did not indicate any significant signs of renal dysfunction.
- MeSH
- Antimanic Agents administration & dosage adverse effects MeSH
- Biomarkers metabolism MeSH
- Bipolar Disorder drug therapy MeSH
- Time Factors MeSH
- Adult MeSH
- Glomerular Filtration Rate MeSH
- Middle Aged MeSH
- Humans MeSH
- Lithium Carbonate administration & dosage adverse effects MeSH
- Kidney Diseases chemically induced epidemiology MeSH
- Aged MeSH
- Kidney Function Tests MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Keywords
- sekundární nefrotický syndrom,
- MeSH
- Anti-Anxiety Agents administration & dosage therapeutic use MeSH
- Biomarkers blood urine MeSH
- Biopsy methods utilization MeSH
- Diuresis physiology drug effects MeSH
- Edema diagnosis etiology complications MeSH
- Drug Therapy MeSH
- Hyperkalemia diagnosis etiology therapy MeSH
- Humans MeSH
- Lithium Carbonate * administration & dosage adverse effects therapeutic use MeSH
- Adolescent MeSH
- Nephrology MeSH
- Nephrotic Syndrome diagnosis etiology MeSH
- Drug-Related Side Effects and Adverse Reactions etiology complications MeSH
- Proteinuria diagnosis etiology complications MeSH
- Anxiety Disorders * diagnosis drug therapy complications MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Vyd. 1. 58 s. : il. ; 20 cm
Informace pro pacienty trpícími poruchami nálad o ochranné terapii, zejména o správném užívání lithia.; Při správném používání přináší lithium bezesporu nejpozoruhodnější pozitiva mezi léky předepisovanými v psychiatrii. Hlavním cílem této publikace je poskytnout pacientům a jejich rodinným příslušníkům nejnovější informace o jeho správném užívání. Kniha vznikla na základě obrovské zkušenosti a přesvědčení, že dobře informovaní pacienti a jejich příbuzní jsou rozhodující součástí správné terapie lithiem. Napsaná neodborným, zato však široké veřejnosti srozumitelným jazykem je tato příručka zdrojem kompletních informací pro maniodepresivní pacienty, jejich rodiny, lékaře i ošetřovatele, kteří o ně pečují.
- MeSH
- Bipolar Disorder drug therapy MeSH
- Depressive Disorder drug therapy MeSH
- Lithium pharmacokinetics pharmacology therapeutic use MeSH
- Lithium Carbonate administration & dosage adverse effects therapeutic use MeSH
- Mood Disorders drug therapy MeSH
- Risk Factors MeSH
- Publication type
- Popular Work MeSH
- Handbook MeSH
- Conspectus
- Farmacie. Farmakologie
- NML Fields
- psychiatrie
- farmakoterapie
- farmacie a farmakologie
- MeSH
- Antidepressive Agents administration & dosage pharmacology classification MeSH
- Anticonvulsants administration & dosage pharmacology therapeutic use MeSH
- Anti-Anxiety Agents administration & dosage pharmacology therapeutic use MeSH
- Depression etiology classification therapy MeSH
- Lithium Carbonate administration & dosage pharmacology therapeutic use MeSH
- Publication type
- Review MeSH
