Does severe affective disorder affect renal function?
2015 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 78, no 6, 630-631 p.Article in journal, Meeting abstract (Other academic) Published
Background: There is a relationship between affective and somatic morbidity. For instance, patients with bipolar affective disorder (BPAD) and schizophrenia have more diabetes mellitus and a higher cardiovascular mortality. Psychotropic medications seem to only partly account for such associations. The aim of the study was to compare renal function of patients with severe affective disorders with the general population. Method: We examined a representative sample of the population between 25 and 74 years (Northern Sweden Monica Study) and all individuals with comparable age in the Swedish county of Norrbotten with a diagnosis of BPAD, schizoaffective disorder or exposure to lithium between 1997 and 2013 as a proxy for severe affective disorder. All patients were included who consented to the review of their medical case notes and who had a serum creatinine level taken at least within one year of our analysis. We compared the most recent creatinine levels and the eGFR ascertained with the CKD-EPI formula. Results: 955 individuals with severe affective disorder (61% female, 39% male) had a serum creatinine measured in the year of study. 1549 persons (52% female, 48% male) were in the control group. Mean age differed significantly (p < 0.01) between control (mean 51.8 years, SD 13.5) and patients (mean 50.4 years, SD 13.3). 37.8% of the patients had never been exposed to lithium during the last 17 years, 14.3% less than one year, 15.2% 1–5 years and 32.7% more than 5 years. Mean eGFR for the control was 90.19 ml/min/1.73 m2 (SD 15.8) and 90.89 (SD 19.5) in the patient group (p = 0.33). Five people had renal function below 30 ml/min, two in the control group (eGFR 15–30) and three in the long-term lithium group (eGFR < 15). There was no statistically significant difference in renal function between patients and controls as measured. But patients were slightly younger than the controls (1.4 year difference in mean age). Only if the “natural” annual decline in GFR was assumed to be 1.5 ml/min or more, the renal function between both groups would be statistically different. Conclusion: Renal function in patients with severe affective disorders may be lower than in the general population. But, the difference is small and probably without clinical significance in most cases. This would speak against relevant other factors inherently linked to severe affective disorders apart from long-term lithium exposure. We will explore this further in forthcoming analyses.
Place, publisher, year, edition, pages
Elsevier, 2015. Vol. 78, no 6, 630-631 p.
IdentifiersURN: urn:nbn:se:umu:diva-105245DOI: 10.1016/j.jpsychores.2015.03.138ISI: 000355060500134OAI: oai:DiVA.org:umu-105245DiVA: diva2:825961