소아청소년 양극성장애 환자에서 리튬 치료에 따른 소변 오스몰랄농도의 변화

• 영문명: Changes in Urine Osmolal Concentration with Lithium Treatment in Children and Youth with Bipolar Disorder
• 발행기관: 대한신경정신의학회
• 저자명: 정지운(Ji-Woon Jeong) 최범성(Bum-Sung Choi) 김대욱(Dae-Wook Kim) 유은라(Eun-Ra Yu) 허성영(Sung-Young Huh) 김성곤(Sung-
• 간행물 정보: 『신경정신의학』제59권 제4호, 319~324쪽, 전체 6쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2020.11.30

영문 초록

Objectives Bipolar disorder has a high rate of recurrence, which can cause problems such as declines in cognitive and social functions. Lithium is the primary medication for preventing recurrence, but the medication compliance is poor owing to side effects that include diarrhea, tremor, polyuria, polydipsia, diabetes insipidus, increased creatinine level, and weight gain. Polyuria and polydipsia also cause voluntary discontinuation of the medication. However, no domestic and international studies have evaluated the direct correlation between lithium therapy and polydipsia in pediatric patients. Therefore, we assessed this relationship by evaluating urine osmolality changes after lithium administration in pediatric patients. Methods This study focused on patients admitted to the Department of Psychiatry, Pusan National University Yangsan Hospital. Patients had bipolar disorder types I or II and other specified bipolar disorders based on the DSM-5, criteria at discharge from December 1, 2018, to April 31, 2020. Urine osmolarity changes from admission to discharge in the patients who used lithium for the first time after admission were reviewed. Results For 47 patients, the change in osmolality was statistically significant (mean, 203.32± 280.68; p<0.001) and significantly higher in those aged <14 years than in those aged ≥14 years (p=0.038). Antipsychotic use and sex-related differences did not affect urine osmolality. Conclusion The first-time users of lithium had significantly reduced urine osmolality at discharge. Considering the lithium effect on the kidneys, a prospective study to identify the relationship between lithium use and polydipsia is necessary.

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양극성장애 리튬 다음증 다뇨 소변 오스몰랄농도 신기능 Bipolar disorder Lithium Polydipsia Polyuria Urine osmolality Kidney function test.