Review: Meta-analysis of the effects of lithium usage on serum creatinine levels
Review: Meta-analysis of the effects of lithium usage on serum creatinine levels
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回顾：锂使用对血清肌酐水平影响的荟萃分析
DOI：
10.1177/0269881109104930
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发表时间：
2010
影响因子：
4.1
通讯作者：
C. Kelly
中科院分区：
文献类型：
--
作者：
R. Paul;J. Minay;C. Cardwell;D. Fogarty;C. Kelly
关于锂对肾功能的影响存在相互矛盾的证据。目的是澄清锂是否影响肾功能，以及在治疗的哪个阶段可能发生任何影响。系统性综述确定了分为三组的23项研究，对其进行了荟萃分析，以确定以下内容：A）在横断面病例对照研究中锂对肾功能的影响，B）在开始锂治疗之前和之后的肾功能研究，C）在已确定锂治疗的患者中进行的长期影响研究。与对照组相比，A组显示研究人群中肌酐统计学显著性增加5.7 μmol/L。平均随访86个月后，B组显示肌酐（2.9 μmol/L）无统计学显著性升高。C组在64个月的平均持续时间内肌酐升高7.0 μmol/L，具有统计学显著性。在该组中还发现，使用锂后肌酐平均增加1.6 μmol/L/年。任何与锂相关的血清肌酐升高在数量上都很小，临床意义值得怀疑。然而，对锂盐治疗患者进行常规肾功能监测是必要的。
There is conflicting evidence concerning lithium’s effect on renal function. The aim is to clarify whether lithium affects kidney function and at what stage of treatment any effect may occur. Systematic review identified 23 studies split into three groups on which meta-analysis was performed to identify the following: A) lithium’s effect on renal function in cross-sectional case-control studies, B) studies of renal function before and after commencement on lithium, C) studies of longer term effect in those already established on lithium therapy. Group A showed a statistically significant increase of 5.7 μmol/L in creatinine in the study population compared with controls. Group B showed a non-statistically significant rise in creatinine (2.9 μmol/L) after a mean follow-up of 86 months. Group C showed a statistically significant increase in creatinine of 7.0 μmol/L over a mean duration of 64 months. An increase in creatinine of an average of 1.6 μmol/L/year on lithium was also identified in this group. Any lithium-associated increase in serum creatinine is quantitatively small and of questionable clinical significance. However, routine renal function monitoring of patients on lithium is essential.