Progressive renal failure and nephrotic syndrome in a patient being treated with Lithium
Insuficiencia renal progresiva y síndrome nefrótico en un paciente en tratamiento con Litio
Read
7208
Timeswas read the article
1987
Total PDF
5221
Total HTML
Share statistics
array:21 [ "pii" => "X2013251409033595" "issn" => "20132514" "doi" => "10.3265/Nefrologia.2009.29.6.5462.en.full" "estado" => "S300" "fechaPublicacion" => "2009-12-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2009;29:613-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3364 "formatos" => array:3 [ "EPUB" => 267 "HTML" => 2613 "PDF" => 484 ] ] "Traduccion" => array:1 [ "es" => array:17 [ "pii" => "X0211699509033598" "issn" => "02116995" "doi" => "10.3265/Nefrologia.2009.29.6.5462.en.full" "estado" => "S300" "fechaPublicacion" => "2009-12-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia. 2009;29:613-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 10380 "formatos" => array:3 [ "EPUB" => 244 "HTML" => 9530 "PDF" => 606 ] ] "es" => array:9 [ "idiomaDefecto" => true "titulo" => "Insuficiencia renal progresiva y síndrome nefrótico en un paciente en tratamiento con Litio" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "613" "paginaFinal" => "614" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Progressive renal failure and nephrotic syndrome in a patient being treated with Lithium" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Arnau, Gema Fernández Fresnedo, S. Sanz de Castro, M. Arias" "autores" => array:4 [ 0 => array:2 [ "Iniciales" => "A." "apellidos" => "Arnau" ] 1 => array:2 [ "nombre" => "Gema" "apellidos" => "Fernández Fresnedo" ] 2 => array:2 [ "Iniciales" => "S." "apellidos" => "Sanz de Castro" ] 3 => array:2 [ "Iniciales" => "M." "apellidos" => "Arias" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "X2013251409033595" "doi" => "10.3265/Nefrologia.2009.29.6.5462.en.full" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251409033595?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699509033598?idApp=UINPBA000064" "url" => "/02116995/0000002900000006/v0_201502091341/X0211699509033598/v0_201502091342/es/main.assets" ] ] "itemSiguiente" => array:17 [ "pii" => "X201325140903351X" "issn" => "20132514" "doi" => "10.3265/Nefrologia.2009.29.6.5488.en.full" "estado" => "S300" "fechaPublicacion" => "2009-12-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2009;29:614-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3980 "formatos" => array:3 [ "EPUB" => 294 "HTML" => 3137 "PDF" => 549 ] ] "en" => array:9 [ "idiomaDefecto" => true "titulo" => "Previous ischaemic optic neuropathy in haemodialysis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "614" "paginaFinal" => "616" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neuropatía óptica isquémica anterior en hemodiálisis" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Roberto León, C. Marinaro" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Luis Roberto" "apellidos" => "León" ] 1 => array:2 [ "Iniciales" => "C." "apellidos" => "Marinaro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699509033512" "doi" => "10.3265/Nefrologia.2009.29.6.5488.en.full" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699509033512?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X201325140903351X?idApp=UINPBA000064" "url" => "/20132514/0000002900000006/v0_201502091611/X201325140903351X/v0_201502091612/en/main.assets" ] "itemAnterior" => array:17 [ "pii" => "X201325140903360X" "issn" => "20132514" "doi" => "10.3265/Nefrologia.2009.29.6.5458.en.full" "estado" => "S300" "fechaPublicacion" => "2009-12-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2009;29:613" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3570 "formatos" => array:3 [ "EPUB" => 284 "HTML" => 2758 "PDF" => 528 ] ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Hyperamylasaemia and bronchoaspiration associated with Lanthanum carbonate" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "613" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hiperamilasemia y broncoaspiración asociadas a Carbonato de Lantano" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "45718078_f1_p613.jpg" "Alto" => 318 "Ancho" => 258 "Tamanyo" => 15112 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rosa Ramos Sánchez, M.A. Azancot, J. Bartolomé" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Rosa" "apellidos" => "Ramos Sánchez" ] 1 => array:2 [ "Iniciales" => "M.A." "apellidos" => "Azancot" ] 2 => array:2 [ "Iniciales" => "J." "apellidos" => "Bartolomé" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699509033602" "doi" => "10.3265/Nefrologia.2009.29.6.5458.en.full" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699509033602?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X201325140903360X?idApp=UINPBA000064" "url" => "/20132514/0000002900000006/v0_201502091611/X201325140903360X/v0_201502091612/en/main.assets" ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Progressive renal failure and nephrotic syndrome in a patient being treated with Lithium" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "613" "paginaFinal" => "614" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "A. Arnau, Gema Fernández Fresnedo, S. Sanz de Castro, M. Arias" "autores" => array:4 [ 0 => array:3 [ "Iniciales" => "A." "apellidos" => "Arnau" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:4 [ "nombre" => "Gema" "apellidos" => "Fernández Fresnedo" "email" => array:1 [ 0 => "nefffg@humv.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 2 => array:3 [ "Iniciales" => "S." "apellidos" => "Sanz de Castro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 3 => array:3 [ "Iniciales" => "M." "apellidos" => "Arias" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, España, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Insuficiencia renal progresiva y síndrome nefrótico en un paciente en tratamiento con Litio" ] ] "textoCompleto" => "<p class="elsevierStylePara">Dear Editor,</p><p class="elsevierStylePara">We report the case of a 48-year-old female patient, treated with lithium for bipolar disorder for more than 20 years, without other special health issues. In December 2008, she was examined for a deteriorating renal function (Cr 2.7mg/dl and FG according to MDRD of 20ml/min/1.73m),<span class="elsevierStyleSup">2</span> her renal function of the previous year being Cr 1.4mg/dl. At the physical examination her blood pressure without any medical treatment was 170/95mmHg. The test carried out revealed Cr of 3.1mg/dl, Ur of 109mg/dl, K of 5.5mEq/l, P 4.7mg/dl, lithaemia of 0.9mEq/l and haemoglobin of 12.8g/dl; the rest of the biochemical parameters being normal. Her urine showed proteinuria of 5.7g/24 h, with 10-12 red blood cells/field in the sediment. The immunological test showed: negative ANA and ANCA, normal immunoglobulin levels and a normal complement system. The ultrasound revealed normal-sized hyperecogenic kidneys. Due to these findings, it was decided to carry out a renal biopsy which showed the following: 5 glomeruli, one with segmental hyalinosis and another with complete sclerosis. Mesangial thickening and diffuse interstitial fibrosis with tubular atrophy and dilation present in those not suffering from sclerosis. Mesangial deposits of IgA (+++) and C3 (+++). Anatomopathological diagnosis of IgA nephropathy with chronic tubulointerstitial nephritis. The patient began treatment with calcium antagonists with an improvement in the pressure figures; however, renal function continued to worsen, which is why it was necessary to prepare for the substitutive treatment.</p><p class="elsevierStylePara">Lithium salts are widely used in bipolar disorder. The treatment of the chronic form of the disorder with these salts is associated with different types of renal damage, including nephrogenic diabetes insipidus, metabolic acidosis, chronic nephritis and hypercalcaemia. The most important predisposing factor is the time of exposure to lithium, while other factors include age, episodes of lithium poisoning and comorbidity. The anatomopathological substrate of the toxicity from lithium is interstitial fibrosis, which can appear 5 years following treatment. At the same time, focal segmental glomerulosclerosis is associated with tubulointerstitial changes. Renal tubular cysts are a sign of tubular damage, which is manifested as dilation of the distal segment and the tubular collector. The progression of nephritis brought about by lithium is slow, considering a drop in the glomerular filtration rate of 2.2ml/min per year of exposure, with a very low rate of terminal chronic kidney disease in the various published studies. Interruption of the treatment with lithium salts does not achieve the recovery of the patient¿s baseline renal function. Instead, in some cases, the deterioration continues at a similar rate following its interruption. It is thought that a point of no return exists, after which renal fibrosis continues despite discontinuing the aggression that triggered it in the first place. This depends on the anatomopathological substrate at that moment, with better response of the illness to small changes. In this instance, the renal biopsy allowed us to position the clinical condition, and it was decided to continue with the lithium treatment. This could not fully justify the patient¿s progress in full view of the biopsy result that was compatible with IgA nephropathy, which justified the clinical condition described. </p>" "pdfFichero" => "P-E-S-A458-EN.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Markowitz GS, Radhakrishnan J, Kambham N, Valeri AM, Hines WH, D¿Agati VD. Lithium nephrotoxicity: a progressive combined glomerular and tubulointerstitial nephropathy. J Am Soc Nephrol 2000;11:1439-48. <a href="http://www.ncbi.nlm.nih.gov/pubmed/10906157" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Presne C, Fakhouri F, Noel LH, et al. Lithium-induced nephropathy: Rate of progression and prognostic factors. Kidney Int 2003;64:585. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12846754" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Grünfeld J-P, Rossier BC. Lithium nephrotoxicity revisited. Nature Rev Nephrol 2009;5:270-6." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002900000006/v0_201502091611/X2013251409033595/v0_201502091612/en/main.assets" "Apartado" => array:4 [ "identificador" => "35436" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002900000006/v0_201502091611/X2013251409033595/v0_201502091612/en/P-E-S-A458-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251409033595?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 8 | 10 | 18 |
| 2024 October | 63 | 31 | 94 |
| 2024 September | 63 | 21 | 84 |
| 2024 August | 68 | 51 | 119 |
| 2024 July | 45 | 31 | 76 |
| 2024 June | 61 | 48 | 109 |
| 2024 May | 62 | 35 | 97 |
| 2024 April | 46 | 26 | 72 |
| 2024 March | 27 | 25 | 52 |
| 2024 February | 29 | 29 | 58 |
| 2024 January | 27 | 21 | 48 |
| 2023 December | 23 | 24 | 47 |
| 2023 November | 30 | 29 | 59 |
| 2023 October | 39 | 28 | 67 |
| 2023 September | 31 | 27 | 58 |
| 2023 August | 37 | 29 | 66 |
| 2023 July | 24 | 34 | 58 |
| 2023 June | 38 | 17 | 55 |
| 2023 May | 43 | 29 | 72 |
| 2023 April | 22 | 13 | 35 |
| 2023 March | 41 | 17 | 58 |
| 2023 February | 40 | 25 | 65 |
| 2023 January | 38 | 20 | 58 |
| 2022 December | 52 | 25 | 77 |
| 2022 November | 43 | 25 | 68 |
| 2022 October | 34 | 34 | 68 |
| 2022 September | 44 | 30 | 74 |
| 2022 August | 51 | 44 | 95 |
| 2022 July | 52 | 40 | 92 |
| 2022 June | 44 | 26 | 70 |
| 2022 May | 37 | 37 | 74 |
| 2022 April | 61 | 43 | 104 |
| 2022 March | 67 | 36 | 103 |
| 2022 February | 69 | 42 | 111 |
| 2022 January | 34 | 27 | 61 |
| 2021 December | 42 | 34 | 76 |
| 2021 November | 39 | 40 | 79 |
| 2021 October | 82 | 39 | 121 |
| 2021 September | 61 | 23 | 84 |
| 2021 August | 89 | 42 | 131 |
| 2021 July | 89 | 29 | 118 |
| 2021 June | 56 | 41 | 97 |
| 2021 May | 52 | 29 | 81 |
| 2021 April | 80 | 56 | 136 |
| 2021 March | 55 | 21 | 76 |
| 2021 February | 70 | 8 | 78 |
| 2021 January | 39 | 9 | 48 |
| 2020 December | 30 | 12 | 42 |
| 2020 November | 41 | 11 | 52 |
| 2020 October | 32 | 13 | 45 |
| 2020 September | 23 | 6 | 29 |
| 2020 August | 34 | 6 | 40 |
| 2020 July | 30 | 13 | 43 |
| 2020 June | 38 | 3 | 41 |
| 2020 May | 31 | 8 | 39 |
| 2020 April | 44 | 17 | 61 |
| 2020 March | 35 | 4 | 39 |
| 2020 February | 59 | 18 | 77 |
| 2020 January | 48 | 20 | 68 |
| 2019 December | 35 | 17 | 52 |
| 2019 November | 50 | 9 | 59 |
| 2019 October | 39 | 10 | 49 |
| 2019 September | 41 | 15 | 56 |
| 2019 August | 27 | 10 | 37 |
| 2019 July | 27 | 15 | 42 |
| 2019 June | 33 | 11 | 44 |
| 2019 May | 29 | 18 | 47 |
| 2019 April | 45 | 28 | 73 |
| 2019 March | 24 | 15 | 39 |
| 2019 February | 17 | 13 | 30 |
| 2019 January | 13 | 10 | 23 |
| 2018 December | 58 | 29 | 87 |
| 2018 November | 73 | 18 | 91 |
| 2018 October | 63 | 9 | 72 |
| 2018 September | 58 | 9 | 67 |
| 2018 August | 41 | 15 | 56 |
| 2018 July | 42 | 16 | 58 |
| 2018 June | 37 | 12 | 49 |
| 2018 May | 39 | 19 | 58 |
| 2018 April | 45 | 5 | 50 |
| 2018 March | 39 | 10 | 49 |
| 2018 February | 31 | 9 | 40 |
| 2018 January | 29 | 8 | 37 |
| 2017 December | 32 | 12 | 44 |
| 2017 November | 27 | 4 | 31 |
| 2017 October | 25 | 6 | 31 |
| 2017 September | 23 | 9 | 32 |
| 2017 August | 19 | 8 | 27 |
| 2017 July | 24 | 7 | 31 |
| 2017 June | 28 | 4 | 32 |
| 2017 May | 17 | 14 | 31 |
| 2017 April | 17 | 9 | 26 |
| 2017 March | 15 | 9 | 24 |
| 2017 February | 28 | 10 | 38 |
| 2017 January | 10 | 5 | 15 |
| 2016 December | 31 | 6 | 37 |
| 2016 November | 26 | 7 | 33 |
| 2016 October | 43 | 6 | 49 |
| 2016 September | 88 | 6 | 94 |
| 2016 August | 133 | 4 | 137 |
| 2016 July | 95 | 0 | 95 |
| 2016 June | 92 | 0 | 92 |
| 2016 May | 97 | 0 | 97 |
| 2016 April | 64 | 0 | 64 |
| 2016 March | 44 | 0 | 44 |
| 2016 February | 63 | 0 | 63 |
| 2016 January | 77 | 0 | 77 |
| 2015 December | 90 | 0 | 90 |
| 2015 November | 76 | 0 | 76 |
| 2015 October | 70 | 0 | 70 |
| 2015 September | 48 | 0 | 48 |
| 2015 August | 56 | 0 | 56 |
| 2015 July | 60 | 0 | 60 |
| 2015 June | 37 | 0 | 37 |
| 2015 May | 34 | 0 | 34 |
| 2015 April | 5 | 0 | 5 |
Show all
