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Lithium and renal and upper urinary tract tumors – results from a nationwide population‐based study
Author(s) -
Kessing Lars Vedel,
Gerds Thomas Alexander,
FeldtRasmussen Bo,
Andersen Per Kragh,
Licht Rasmus W
Publication year - 2015
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/bdi.12344
Subject(s) - hazard ratio , lithium (medication) , medicine , population , antipsychotic , medical prescription , neuroleptic malignant syndrome , bipolar disorder , urinary system , pediatrics , gastroenterology , urology , confidence interval , psychiatry , schizophrenia (object oriented programming) , pharmacology , environmental health
Objectives A recent alarming finding suggested an increased risk of renal tumors among long‐term lithium users. The objectives of the present study were to estimate rates of renal and upper urinary tract tumors ( RUT ), malignant and benign, among individuals exposed to successive prescriptions for lithium, anticonvulsants, and other psychotropic agents used for bipolar disorder, and among unexposed individuals. Methods This was a nationwide, population‐based longitudinal study including time‐specific data from all individuals exposed to lithium (n = 24,272) or anticonvulsants (n = 386,255), all individuals with a diagnosis of bipolar disorder (n = 9,651), and a randomly selected sample of 1,500,000 from the Danish population. The study period was from 1995 to 2012, inclusive. Outcomes were hazard rate ratios ( HR ) for RUT in three groups: (i) combined malignant and benign, (ii) malignant, and (iii) benign. Analyses were adjusted for the number of prescriptions for lithium/anticonvulsants, antipsychotic agents, antidepressants, and use of all other types of medication; age; gender; employment status; calendar year; and a diagnosis of bipolar disorder. Results Continued treatment with lithium was not associated with increased rates of RUT [adjusted HR malignant or benign: 0.67–1.18, p (trend) = 0.70; adjusted HR malignant: 0.61–1.34, p (trend) = 0.90; adjusted HR benign: 0.74–1.18, p (trend) = 0.70]. Similarly, continued treatment with anticonvulsants was not associated with increased rates of RUT [adjusted HR malignant or benign: 0.97–1.18, p (trend) = 0.10; adjusted HR malignant: 0.82–1.15, p (trend) = 0.80; adjusted HR benign: 0.94–1.36, p (trend) = 0.20]. The associations were confirmed among the 9,651 patients with a diagnosis of bipolar disorder. Conclusions Treatment with lithium is not associated with increased rates of RUT .