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首页> 外文期刊>Journal of psychopharmacology >Lithium intoxication: Incidence, clinical course and renal function - a population-based retrospective cohort study
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Lithium intoxication: Incidence, clinical course and renal function - a population-based retrospective cohort study

机译：锂中毒：发病率，临床病程和肾功能-基于人群的回顾性队列研究

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摘要

When prescribing lithium, the risk of toxicity remains a concern. In this study, we examined a cohort of patients exposed to lithium between 1997 and 2013. The aims of this study were to determine the frequency of lithium intoxication and to evaluate the clinical course and changes in renal function. Of 1340 patients, 96 had experienced at least one episode of lithium levels 1.5 mmol/L, yielding an incidence of 0.01 per patient-year. Seventy-seven patients available for review had experienced 91 episodes, of whom 34% required intensive care and 13% were treated with haemodialysis. There were no fatalities. Acute kidney injury occurred, but renal function at baseline was not different to renal function after the episode. Renal impairment was often associated with co-morbidities and other factors. Both intermittent and continuous-venovenous haemodialysis were used, but the clearance of continuous-venovenous haemodialysis can be too low in cases where large amounts of lithium have been ingested. Saline and forced diuresis have been used and are safe. Lithium intoxication seems rare and can be safely managed in most cases. Physicians should not withhold lithium for fear of intoxication in patients who benefit from it. Yet, physicians should have a low threshold to screen for toxicity.
机译：处方锂时，毒性风险仍然值得关注。在这项研究中，我们检查了1997年至2013年之间接触锂的患者队列。该研究的目的是确定锂中毒的频率，并评估临床过程和肾功能的变化。在1340位患者中，有96位经历了至少一次锂水平1.5 mmol / L的发作，每患者年的发生率为0.01。可供复查的77例患者经历了91次发作，其中34％需要重症监护，而13％接受了血液透析治疗。没有死亡。发生了急性肾损伤，但基线后的肾功能与发作后的肾功能没有差异。肾脏损害通常与合并症和其他因素有关。间歇性和连续静脉血液透析都可以使用，但是如果摄入大量锂，连续静脉血液透析的清除率可能会太低。已使用盐水和强制利尿剂并且安全。锂中毒似乎很少见，在大多数情况下可以安全处理。医生不应该扣留锂，因为担心会从中受益的患者中毒。但是，医师筛查毒性的阈值应较低。

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