Managing polyuria during lithium treatment: a preliminary prospective observational study

Simple item page
dc.contributor.authorKinahan, James C.
dc.contributor.authorNí Chorcoráin, Aoife
dc.contributor.authorCunningham, Sean K.
dc.contributor.authorBarry, Siobhan
dc.contributor.authorKelly, Brendan
dc.date.accessioned2019-05-08T11:12:32Z
dc.date.available2019-05-08T11:12:32Z
dc.date.issued2019-04-10
dc.date.updated2019-04-17T09:32:50Z
dc.description.abstractObjectives:Lithium-treated patients with polyuria are at increased risk of lithium toxicity. We aimed to describe the clinical benefits and risks of different management strategies for polyuria in community lithium-treated patients.Methods:This is a naturalistic, observational, prospective 12-month cohort study of lithium-treated patients with polyuria attending a community mental health service in Dublin, Ireland. When polyuria was detected, management changed in one of four ways: (a) no pharmacological change; (b) lithium dose decrease; (c) lithium substitution; or (d) addition of amiloride.Results:Thirty-four participants were diagnosed with polyuria and completed prospective data over 12 months. Mean 24-hour urine volume decreased from 4852 to 4344 ml (p = 0.038). Mean early morning urine osmolality decreased from 343 to 338 mOsm/kg (p = 0.823). Mean 24-hour urine volume decreased with each type of intervention but did not attain statistical significance for any individual intervention group. Mean early morning urine osmolality decreased in participants with no pharmacological change and increased in participants who received a change in medication but these changes did not attain statistical significance. Only participants who discontinued lithium demonstrated potentially clinically significant changes in urine volume (mean decrease 747 ml in 24 hours) and early morning urine osmolality (mean increase 31 mOsm/kg) although this was not definitively proven, possibly owing to power issues.Conclusions:Managing polyuria by decreasing lithium dose does not appear to substantially improve objective measures of renal tubular dysfunction, whereas substituting lithium may do so. Studies with larger numbers and longer follow-up would clarify these relationships.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationKinahan, J. C., Ní Chorcoráin, A., Cunningham, S., Barry, S. and Kelly, B. D. (2019) 'Managing polyuria during lithium treatment: a preliminary prospective observational study', Irish Journal of Psychological Medicine, pp. 1-8. doi: 10.1017/ipm.2019.9en
dc.identifier.doi10.1017/ipm.2019.9en
dc.identifier.eissn2051-6967
dc.identifier.endpage8en
dc.identifier.issn0790-9667
dc.identifier.journaltitleIrish Journal of Psychological Medicineen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/7865
dc.language.isoenen
dc.publisherCambridge University Press on behalf of the College of Psychiatrists of Irelanden
dc.relation.urihttps://www.cambridge.org/core/article/managing-polyuria-during-lithium-treatment-a-preliminary-prospective-observational-study/43330E5490EEC558DC156340798D3225
dc.rights© 2019, College of Psychiatrists of Ireland. Published by Cambridge University Press. All rights reserved.en
dc.subjectLithiumen
dc.subjectPolyuriaen
dc.subjectRenal tubular dysfunctionen
dc.subjectNephrogenic diabetes insipidusen
dc.subjectAmilorideen
dc.titleManaging polyuria during lithium treatment: a preliminary prospective observational studyen
dc.typeArticle (peer-reviewed)en
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
managing_polyuria_during_lithium_treatment_a_preliminary_prospective_observational_study.pdf
Size:
118.53 KB
Format:
Adobe Portable Document Format
Description:
Published Version
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
2.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Medicine - Journal Articles