Circulating antithyroid antibodies contribute to the decrease of glomerular filtration rate in lithium-treated patients: a longitudinal study

Abstract Background Concerns about the adverse effects of long-term treatment with lithium include reduced renal function. In the present study, we examined comorbidities which may be associated with chronic kidney disease in a cohort of patients treated with lithium for up to 41 years. Methods We s...

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Main Authors: Alberto Bocchetta, Luca Ambrosiani, Gioia Baggiani, Claudia Pisanu, Caterina Chillotti, Raffaella Ardau, Fernanda Velluzzi, Doloretta Piras, Andrea Loviselli, Antonello Pani
Format: Article
Language:English
Published: SpringerOpen 2018-03-01
Series:International Journal of Bipolar Disorders
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40345-017-0114-4
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author Alberto Bocchetta
Luca Ambrosiani
Gioia Baggiani
Claudia Pisanu
Caterina Chillotti
Raffaella Ardau
Fernanda Velluzzi
Doloretta Piras
Andrea Loviselli
Antonello Pani
author_facet Alberto Bocchetta
Luca Ambrosiani
Gioia Baggiani
Claudia Pisanu
Caterina Chillotti
Raffaella Ardau
Fernanda Velluzzi
Doloretta Piras
Andrea Loviselli
Antonello Pani
author_sort Alberto Bocchetta
collection DOAJ
description Abstract Background Concerns about the adverse effects of long-term treatment with lithium include reduced renal function. In the present study, we examined comorbidities which may be associated with chronic kidney disease in a cohort of patients treated with lithium for up to 41 years. Methods We studied 394 patients who were treated with lithium for ≥ 5 years. The potential role of comorbidities (diabetes, concurrent antihypertensive medication, treatment with l-thyroxine, and presence of antithyroid peroxidase/microsomes, anti-thyroglobulin, and/or anti-thyrotropin-receptor antibodies) was analysed. We focused on the categories of patients with an estimated glomerular filtration rate (eGFR) lower than 60 or 45 mL/min/1.73 m2 as calculated from serum creatinine according to the Modification of Diet in Renal Disease Study Group. We applied multivariate regression analysis and Cox survival analysis to study the effects exerted by sex, age, duration of lithium treatment, and comorbidities using eGFR categories as the dependent variable. Kaplan–Meier curves were generated to measure the time to decline to an eGFR lower than 45 mL/min/1.73 m2 in patients with positive or negative thyroid antibodies. Results Age was associated with a decline to an eGFR lower than 60 mL/min/1.73 m2 after controlling for sex, duration of lithium treatment, and comorbidities. Circulating thyroid antibodies were associated with a decline to an eGFR lower than 45 mL/min/1.73 m2. Conclusions The present study is the first to suggest a potential role of circulating thyroid antibodies in the severe decline of eGFR in lithium-treated patients.
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spelling doaj.art-1568a54c6f3d4fe2973acd99146e42ec2022-12-22T02:26:17ZengSpringerOpenInternational Journal of Bipolar Disorders2194-75112018-03-01611810.1186/s40345-017-0114-4Circulating antithyroid antibodies contribute to the decrease of glomerular filtration rate in lithium-treated patients: a longitudinal studyAlberto Bocchetta0Luca Ambrosiani1Gioia Baggiani2Claudia Pisanu3Caterina Chillotti4Raffaella Ardau5Fernanda Velluzzi6Doloretta Piras7Andrea Loviselli8Antonello Pani9Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of CagliariSection of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of CagliariSection of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of CagliariSection of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of CagliariUnit of Clinical Pharmacology, Cagliari University HospitalUnit of Clinical Pharmacology, Cagliari University HospitalDepartment of Medical Sciences and Public Health, University of CagliariNephrology, Dialysis and Transplantation Unit, ‘Giuseppe Brotzu’ HospitalDepartment of Medical Sciences and Public Health, University of CagliariNephrology, Dialysis and Transplantation Unit, ‘Giuseppe Brotzu’ HospitalAbstract Background Concerns about the adverse effects of long-term treatment with lithium include reduced renal function. In the present study, we examined comorbidities which may be associated with chronic kidney disease in a cohort of patients treated with lithium for up to 41 years. Methods We studied 394 patients who were treated with lithium for ≥ 5 years. The potential role of comorbidities (diabetes, concurrent antihypertensive medication, treatment with l-thyroxine, and presence of antithyroid peroxidase/microsomes, anti-thyroglobulin, and/or anti-thyrotropin-receptor antibodies) was analysed. We focused on the categories of patients with an estimated glomerular filtration rate (eGFR) lower than 60 or 45 mL/min/1.73 m2 as calculated from serum creatinine according to the Modification of Diet in Renal Disease Study Group. We applied multivariate regression analysis and Cox survival analysis to study the effects exerted by sex, age, duration of lithium treatment, and comorbidities using eGFR categories as the dependent variable. Kaplan–Meier curves were generated to measure the time to decline to an eGFR lower than 45 mL/min/1.73 m2 in patients with positive or negative thyroid antibodies. Results Age was associated with a decline to an eGFR lower than 60 mL/min/1.73 m2 after controlling for sex, duration of lithium treatment, and comorbidities. Circulating thyroid antibodies were associated with a decline to an eGFR lower than 45 mL/min/1.73 m2. Conclusions The present study is the first to suggest a potential role of circulating thyroid antibodies in the severe decline of eGFR in lithium-treated patients.http://link.springer.com/article/10.1186/s40345-017-0114-4LithiumRenal insufficiencyChronicGlomerular filtration rateThyroid microsomal antibodiesAnti-thyroglobulin
spellingShingle Alberto Bocchetta
Luca Ambrosiani
Gioia Baggiani
Claudia Pisanu
Caterina Chillotti
Raffaella Ardau
Fernanda Velluzzi
Doloretta Piras
Andrea Loviselli
Antonello Pani
Circulating antithyroid antibodies contribute to the decrease of glomerular filtration rate in lithium-treated patients: a longitudinal study
International Journal of Bipolar Disorders
Lithium
Renal insufficiency
Chronic
Glomerular filtration rate
Thyroid microsomal antibodies
Anti-thyroglobulin
title Circulating antithyroid antibodies contribute to the decrease of glomerular filtration rate in lithium-treated patients: a longitudinal study
title_full Circulating antithyroid antibodies contribute to the decrease of glomerular filtration rate in lithium-treated patients: a longitudinal study
title_fullStr Circulating antithyroid antibodies contribute to the decrease of glomerular filtration rate in lithium-treated patients: a longitudinal study
title_full_unstemmed Circulating antithyroid antibodies contribute to the decrease of glomerular filtration rate in lithium-treated patients: a longitudinal study
title_short Circulating antithyroid antibodies contribute to the decrease of glomerular filtration rate in lithium-treated patients: a longitudinal study
title_sort circulating antithyroid antibodies contribute to the decrease of glomerular filtration rate in lithium treated patients a longitudinal study
topic Lithium
Renal insufficiency
Chronic
Glomerular filtration rate
Thyroid microsomal antibodies
Anti-thyroglobulin
url http://link.springer.com/article/10.1186/s40345-017-0114-4
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