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Capillary electrophoresis mass spectrometry as a potential tool to detect lithium-induced nephropathy: Preliminary results.

Abstract：

:Lithium remains the treatment of choice for many patients suffering from bipolar disorder. However, long-term treatment with lithium carries the potential to cause renal and thyroid dysfunction. Lithium-induced nephropathies are characterised by deterioration of urinary concentrating ability as well as, less frequently, a progressive and potentially irreversible decrease in glomerular filtration rate (GFR). Pathological changes after treatment with lithium include both tubulointerstitial and glomerular changes. Besides monitoring of the kidney-function, no screening-instruments exist for early identification of patients at risk of lithium-induced nephropathy. CE-MS (capillary electrophoresis coupled to a mass spectrometer) is a new technique that has been applied to the differential diagnosis of nephropathies. We sought to determine if CE-MS can be used to identify lithium-induced renal changes. A urine-sample was obtained from 14 subjects (7 males, 7 females, mean age 51.1 years) under long-term treatment with lithium (mean duration 17.4 years, range 8-35 years) without known nephropathy (mean creatinine 0.96 mg/dl; range 0.7-1.6). Urine samples were stored at -20 degrees C until analysis. CE-MS was performed according to standard procedures and a screen for nephropathies was used. Among the 14 urine samples, two subjects tested positive for a nephropathy. One further subject had a borderline result. Since 3/14 subjects with no known nephropathy showed some degree of pathological findings, CE-MS from a urine-sample may be helpful for the early detection of renal damage under treatment with lithium. However, a specific screen for lithium-induced nephropathies still needs to be developed.

journal_name

Prog Neuropsychopharmacol Biol Psychiatry

journal_title

Progress in neuro-psychopharmacology & biological psychiatry

authors

Raedler TJ,Wittke S,Jahn H,Koessler A,Mischak H,Wiedemann K

doi

10.1016/j.pnpbp.2007.11.015

subject

Has Abstract

pub_date

2008-04-01 00:00:00

pages

673-8

issue

eissn

0278-5846

issn

1878-4216

pii

S0278-5846(07)00401-0

journal_volume

pub_type

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Capillary electrophoresis mass spectrometry as a potential tool to detect lithium-induced nephropathy: Preliminary results.