Hemodialysis Treatment for Patients with Lithium Poisoning

Yu-Hsin Liu, Kai-Fan Tsai, Pai-Chin Hsu, Meng-Hsuan Hsieh, Jen-Fen Fu, I-Kuan Wang, Shou-Hsuan Liu, Cheng-Hao Weng, Wen-Hung Huang, Ching-Wei Hsu and Tzung-Hai Yen ()
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Yu-Hsin Liu: Department of Anaesthesiology, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
Kai-Fan Tsai: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
Pai-Chin Hsu: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
Meng-Hsuan Hsieh: Division of Nephrology, Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330, Taiwan
Jen-Fen Fu: Department of Medical Research, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
I-Kuan Wang: Department of Nephrology, China Medical University Hospital, Taichung 406, Taiwan
Shou-Hsuan Liu: College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Cheng-Hao Weng: College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Wen-Hung Huang: College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Ching-Wei Hsu: College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Tzung-Hai Yen: College of Medicine, Chang Gung University, Taoyuan 333, Taiwan

IJERPH, 2022, vol. 19, issue 16, 1-9

Abstract: Background: Hemodialysis is often recommended to treat severe lithium poisoning. Nevertheless, the application rate of hemodialysis in patients with lithium poisoning is varied across different groups and the effect of hemodialysis is still undetermined. Therefore, this study aimed to analyze the hemodialysis rate of patients with lithium poisoning and to explore the clinical features of lithium-poisoned-patients treated or untreated with hemodialysis. Methods: Between 2001 and 2019, 36 patients treated at the Chang Gung Memorial Hospital for the management of lithium poisoning were stratified according to whether they were treated with hemodialysis ( n = 7) or not ( n = 29). Results: The patients were aged 50.7 ± 18.1 years. The poisoning patterns were acute on chronic (61.1%), chronic (25.0%) and acute (13.9%). The precipitating factors of dehydration and infection were noted in 36.1% and 25.0% of patients, respectively. Bipolar disorder (72.2%), depressive disorder (27.8%) and psychotic disorder (11.1%) were the top three psychiatric comorbidities. The hemodialysis group not only had a lower Glasgow Coma Scale (GCS) score ( p = 0.001) but also had a higher respiratory failure rate ( p = 0.033), aspiration pneumonia rate ( p = 0.033) and acute kidney injury network (AKIN) score ( p = 0.002) than the non-hemodialysis group. Although none of the patients died of lithium poisoning, the hemodialysis group required more endotracheal intubation ( p = 0.033), more intensive care unit admission ( p = 0.033) and longer hospitalization ( p = 0.007) than the non-hemodialysis group. Conclusion: The analytical results revealed zero mortality rate and low hemodialysis rate (1.9%). Compared with patients without hemodialysis, patients receiving hemodialysis suffered severer lithium-associated complications and needed a more intensive care unit admission and longer hospital stay.

Keywords: lithium; poisoning; psychiatric comorbidity; hemodialysis; acute kidney injury network score; mortality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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