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Biomedical subjects

A Amdisen

Publications and source records attributed to A Amdisen.

At least 55 records · Page 3Linked to original sources
PubMed1979

[Recent developments in lithium treatment: is the kidney affection dangerous? (author's transl)].

In our hospital, we are studying the renal function of more than 200 patients under lithium treatment. The glomerular function seems to be affected to a small extent, even by long-term lithium administration, and there have been no instances of progressive deterioration of renal function with azotemia. Most of the patients have impaired water reabsorption with polyuria and polydipsia. This is frequently combined with lowered concentrating ability. Polyuria and lowered concentrating ability are not in themselves life-threatening. However, development of dehydration may lead to lithium poisoning, and patients under lithium treatment should be advised to drink extra fluid under circumstances when the fluid balance may become negative. Further studies are required for definitive recommendations concerning extra monitoring of kidney function and lowering of lithium doses.

Bipolar Disorder↗
PubMed1978

Urinary excretion of albumin beta2-microglobulin and free light chains during lithium treatment.

Albumin, beta2-microglobulin and free light chains were determined in urine in nine manic-depressive patients before and at intervals during three months of lithium treatment (longitudinal study). The same determinations were carried out in twenty-seven manic-depressive patients who had been treated with lithium for 3 months to 20 years and also in a control group (transversal study). There were no statistically significant changes in urinary excretions of albumin, beta2-microglobulin and free light chains during the longitudinal study. In one patient albumin excretion gradually increased during the study and remained elevated on reexamination 1 year later. No significant differences were found between the lithium treated patients and control subjects in the transversal study in either albumin, beta2-microglobulin or free light chain excretion. It is not clear whether the increased and sustained albumin excretion in one of the patients was due to lithium or was conincidental. The study shows that in most patients lithium treatment does not affect renal protein excretion.

Adult↗
PubMed1978

A clinical trial comparing sustained release amitryptyline (Saroten Retard) and conventional amitriptyline tablets (Saroten) in endogenously depressed patients with simultaneous determination of serum levels of amitryptyline and nortriptyline.

The clinical effect of a sustained release preparation of amitriptyline has been compared with that of conventional amitriptyline tablets in a double-blind cross-over study with 24 patients suffering from endogenous depression. The sustained release preparation was given in a single evening dose (9 p.m.) of two thirds the total daily dose of conventional tablets, which was given in a three times-a-day regimen (8 a.m., 12 a.m. and 9 p.m.). Serum concentrations of amitriptyline and its active metabolite, nortriptyline, were determined. No difference was found between the two preparations as regards either clinical effect or side effects. No correlation could be shown between the clinical effects and the serum concentrations of amitriptyline and nortriptyline.

Adolescent↗
PubMed1978

Plasma renin concentration during lithium therapy.

Plasma renin concentration was determined in patients given lithium treatment. In longitudinal study plasma renin concentration was determined in nine patients before the start of lithium treatment and at intervals during 3 months of treatment. In a transversal study, 18 patients given lithium treatment for 2--20 years were compared with 11 control persons. In the longitudinal study, plasma renin concentrations did not, during lithium treatment, deviate significantly from pre-treatment values. In the transversal study, values in the lithium treated patients did not differ significantly from values in the control group. There were no correlations, in the transversal study, between serum lithium concentrations and plasma renin concentrations. Our study indicates that the plasma renin concentration remains unaffected by lithium administered in nontoxic doses.

Adult↗
PubMed1978

Lithium intoxication. (Report of 23 cases and review of 100 cases from the literature).

Twenty-three patients were studied, 21 of whom developed intoxication during maintenance therapy with a lithium dosage which had been unchanged for months to years. Toxic effects on brain, heart and kidneys were found and the severity of lithium intoxication seemed to depend on at least three factors: the height of the serum lithium concentration (SLi), the duration of lithium intoxication and individual tolerance. Disorders of water and electrolyte metabolism preceded lithium intoxication in the majority of the patients. Water loss due to impaired renal concentrating ability seemed to be a major predisposing factor. Renal insufficiency was apparent in 17 of the patients on admission and five of these did not regain normal renal function. In seven patients, renal biopsy showed abnormalities which suggest that a chronic nephropathy, possibly caused by lithium, might be another predisposing factor. Treatment with sodium chloride infusion had no specific effect on lithium excretion and led to hypernatraemia in some patients and is therefore not recommended. Hemodialysis is the most effective method available for removing the lithium ion from intoxicated patients. Hemodialysis should be carried out long enough to secure a SLi of less than 1 mmol/l after redistribution of lithium in the body. Treatment by peritoneal dialysis is appropriate only if hemodialysis facilities are unavailable. Lithium intoxication is a serious condition. Of the 23 patients reported, two died and two developed persisting neurological sequelae. The best way to prevent lithium intoxication is to control the serum concentration and to assess renal function and renal concentrating ability regularly during therapy.

Acute Kidney Injury↗
PubMed1977

Reduced renal calcium excretion during lithium therapy.

The renal excretion of calcium was determined in ten subjects before and at intervals during 3 months of lithium treatment. The calcium excretion fell by more than 40% within the first week of treatment and remained low throughout the treatment period. The reduction in urinary calcium excretion could be accounted for by an increase in fractional tubular reabsorption of calcium. There were no changes in serum calcium or inorganic phosphate, nor in urinary inorganic phosphate. The results indicate that lithium interferes with the regulation of calcium metabolism.

Adult↗
PubMed1977

Plasma prolactin during lithium treatment.

Plasma prolactin was determined in a longitudinal study, where -9 manic-depressive patients were examined before lithium treatment and at various times during the treatment with the aim of unravelling a possible association between initial changes in water and sodium balance during lithium treatment and changes in plasma prolactin level. No significant changes were found, nor could any correlation between serum lithium and plasma prolactin be established. Some reports have indicated association between breast cancer and prolonged elevated plasma prolactin, such as is seen during treatment with phenothiazines and reserpine. In a transversal study, determination of plasma prolactin during long-term lithium treatment in 26 patients did not reveal any elevation compared with 16 controls. Lithium is accordingly not among the drugs which produce prolonged elevation of plasma prolactin.

Adult↗
PubMed1977

Plasma renin activity during lithium treatment of patients.

Plasma renin activity (PRA) was determined in patients given lithium treatment. In a longitudinal study PRA was determined in 9 patients before the start of lithium treatment and at intervals during 3 months of treatment. The activity was increased significantly above pretreatment values on day 8 of the treatment; thereafter it fell to pretreatment values. In a transversal study 18 patients given lithium treatment for 2-20 years were compared with 11 control persons. PRA did not differ significantly between the two groups. The results indicate that PRA rises transiently shortly after start of lithium treatment and thereafter falls to pretreatment values where it remains even under prolonged lithium administration.

Adult↗
PubMed1977

Plasma aldosterone and magnesium in serum and urine during lithium treatment.

Serum magnesium, urinary magnesium excretion and plasma aldosterone were determined in 8 manic-depressive before and at intervals during 3 months of lithium treatment (longitudinal study), and in 27 manic-depressive patients who had been treated with lithium for 3 months to 20 years (transversal study). In the longitudinal study urinary magnesium excretion and urine flow increased slightly after 1-3 months of therapy; serum magnesium and plasma aldosterone were unchanged. In the transversal study urinary magnesium excretion, serum magnesium and plasma aldosterone were within normal limits, and they did not differ significantly from levels in the longitudinal study. No correlation was found between serum magnesium or urinary magnesium excretion and plasma aldosterone in either study. The results indicate that changes in urinary magnesium excretion during lithium therapy are not mediated via changes in plasma aldosterone, but may be secondary to diminished renal water reabsorption induced by lithium.

Adult↗
PubMed1977

Plasma renin substrate during lithium treatment.

Inspired from experiments in animals, plasma renin substrate was determined in patients given lithium treatment. In a longitudinal study, renin substrate was determined in 9 patients before the start of lithium treatment and at intervals during 3 months of treatment. In a transversal study, 18 patients on lithium treatment for 2--20 years were compared with 11 control persons. In the longitudinal study, plasma renin substrate values did not, during lithium treatment, deviate significantly from pretreatment values. In the transversal study, values in the lithium-treated patients did not differ significantly from values in the control group. There were no correlations between serum lithium concentrations and plasma renin substrate values. Our study indicates that plasma renin substrate remains unaffected by lithium treatment of manic-depressive patients.

Adult↗
PubMed1977

Renal function and renal pathology in patients with lithium-induced impairment of renal concentrating ability.

Lithium-induced impairment of renal concentrating ability is regarded as a harmless side effect of lithium treatment. This report presents investigations of renal function and renal pathology in 13 patients with reduced renal concentrating ability arising during lithium treatment. The reduced concentrating ability parallels histological damage and is a sign of lithium-induced chronic nephropathy.

Adult↗
PubMed1977

Parathyroid hormone in serum during lithium therapy.

In ten patients parathyroid hormone, urinary calcium excretion, and fractional tubular reabsorption of calcium were determined at intervals during three months of lithium treatment. Parathyroid hormone increased more than 40% within the first week and remained elevated throughout the treatment period. Calcium excretion fell by more than 30% within the first week and remained low throughout the treatment period. The reduction in urinary calcium excretion could be accounted for by an increase in fractional tubular reabsorption of calcium. There were no significant changes in serum calcium and inorganic phosphate or in urinary inorganic phosphate. The results indicate that lithium treatment affects the hormonal regulation of calcium metabolism.

Adult↗
PubMed1975

[The significance of the serum lithium level for lithium therapy of phasic psychoses (author's transl)].

Lithium is an effective substance for the treatment of frequently recurring manias and depressions. But its use requires some precautionary measures which must be carefully attended to. Thus, the initial dose must be low. Then the serum lithium level must be determined after one week. The best time to take the blood sample is about 12 hours after the last dose of lithium. The dosage is adjusted according to the serum lithium level. Subsequent adjustments are frequently necessary during the first few weeks of treatment until the optimal serum lithium level for the individual patient has been found.

Age Factors↗