Risk factors for polyuria in a cross-section of community psychiatric lithium-treated patients
Corresponding Author
James Conor Kinahan
UCD School of Medicine and Medical Science, Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, Dublin, Ireland
Corresponding author:
James Conor Kinahan
UCD School of Medicine and Medical Science
Department of Adult Psychiatry
University College Dublin
Mater Misericordiae University Hospital
63 Eccles Street
Dublin 7
Ireland
Fax: +35318309323
E-mail: [email protected]
Search for more papers by this authorAoife NiChorcorain
Department of Psychiatry, Cork University Hospital, Cork, Ireland
Search for more papers by this authorSean Cunningham
St Vincent's University Hospital, Elm Park, Dublin, Ireland
Search for more papers by this authorAideen Freyne
St Vincent's University Hospital, Elm Park, Dublin, Ireland
Search for more papers by this authorColm Cooney
St Vincent's University Hospital, Elm Park, Dublin, Ireland
Search for more papers by this authorBrendan D Kelly
UCD School of Medicine and Medical Science, Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, Dublin, Ireland
Search for more papers by this authorCorresponding Author
James Conor Kinahan
UCD School of Medicine and Medical Science, Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, Dublin, Ireland
Corresponding author:
James Conor Kinahan
UCD School of Medicine and Medical Science
Department of Adult Psychiatry
University College Dublin
Mater Misericordiae University Hospital
63 Eccles Street
Dublin 7
Ireland
Fax: +35318309323
E-mail: [email protected]
Search for more papers by this authorAoife NiChorcorain
Department of Psychiatry, Cork University Hospital, Cork, Ireland
Search for more papers by this authorSean Cunningham
St Vincent's University Hospital, Elm Park, Dublin, Ireland
Search for more papers by this authorAideen Freyne
St Vincent's University Hospital, Elm Park, Dublin, Ireland
Search for more papers by this authorColm Cooney
St Vincent's University Hospital, Elm Park, Dublin, Ireland
Search for more papers by this authorBrendan D Kelly
UCD School of Medicine and Medical Science, Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, Dublin, Ireland
Search for more papers by this authorAbstract
Objectives
Polyuria increases the risk of dehydration and lithium toxicity in lithium-treated patients. Risk factors have been inconsistently described and the variance of this adverse effect remains poorly understood. This study aimed to establish independent risk factors for polyuria in a community, secondary-level lithium-treated sample of patients.
Methods
This was a cross-sectional study of the lithium-treated patients attending a general adult and an old age psychiatry service. Participants completed a 24-hour urine collection. Urine volume and the presence of polyuria were the outcomes of interest. The relationship between outcome and the participant's demographic and clinical characteristics was explored with univariable and multivariable analysis.
Results
A total of 122 participants were included in the analysis, with 38% being diagnosed with polyuria. Female gender and increased body weight independently predicted the presence of polyuria (standardized regression coefficient 1.01 and 0.94, respectively; p = 0.002 and p = 0.003, respectively). Female gender and increased body weight, lithium dose, and duration of lithium treatment independently predicted higher 24-hour urine volumes (standardized regression coefficients 0.693, p < 0.0005; 0.791, p < 0.0005; 0.276, p = 0.043; 0.181, p = 0.034, respectively). Of three different weight metrics, lean body weight was the most predictive.
Conclusions
Female gender and increased body weight explain part of the variance of this adverse effect. Both risk factors offer fresh insights into the pathophysiology of this potentially reversible and dangerous adverse effect of lithium treatment. Future research should focus on understanding the differences between the genders and between different body compositions in terms of lithium pharmacokinetics and pharmacodynamics.
Supporting Information
| Filename | Description |
|---|---|
| bdi12235-sup-0001-TableS1-S3.docxWord document, 29.8 KB | Table S1. Characteristics of the sample stratified by gender Table S2. Multivariable logistic regression models of the P30 eCER sample Table S3. Multivariable linear regression results of the P30 eCER sample |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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