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Comment published on 17 May 2023, see Int. J. Environ. Res. Public Health 2023, 20(10), 5843.
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Article

Hemodialysis Treatment for Patients with Lithium Poisoning

by
Yu-Hsin Liu
1,
Kai-Fan Tsai
2,
Pai-Chin Hsu
2,
Meng-Hsuan Hsieh
3,
Jen-Fen Fu
4,5,
I-Kuan Wang
6,
Shou-Hsuan Liu
5,7,
Cheng-Hao Weng
5,7,
Wen-Hung Huang
5,7,
Ching-Wei Hsu
5,7 and
Tzung-Hai Yen
5,7,*
1
Department of Anaesthesiology, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
2
Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
3
Division of Nephrology, Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330, Taiwan
4
Department of Medical Research, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
5
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
6
Department of Nephrology, China Medical University Hospital, Taichung 406, Taiwan
7
Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2022, 19(16), 10044; https://doi.org/10.3390/ijerph191610044
Submission received: 25 July 2022 / Accepted: 10 August 2022 / Published: 15 August 2022
(This article belongs to the Special Issue The Fascinating World of Lithium)
Review Reports Versions Notes

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 lithium; poisoning; psychiatric comorbidity; hemodialysis; acute kidney injury network score; mortality

Share and Cite

MDPI and ACS Style

Liu, Y.-H.; Tsai, K.-F.; Hsu, P.-C.; Hsieh, M.-H.; Fu, J.-F.; Wang, I.-K.; Liu, S.-H.; Weng, C.-H.; Huang, W.-H.; Hsu, C.-W.; et al. Hemodialysis Treatment for Patients with Lithium Poisoning. Int. J. Environ. Res. Public Health 2022, 19, 10044. https://doi.org/10.3390/ijerph191610044

AMA Style

Liu Y-H, Tsai K-F, Hsu P-C, Hsieh M-H, Fu J-F, Wang I-K, Liu S-H, Weng C-H, Huang W-H, Hsu C-W, et al. Hemodialysis Treatment for Patients with Lithium Poisoning. International Journal of Environmental Research and Public Health. 2022; 19(16):10044. https://doi.org/10.3390/ijerph191610044

Chicago/Turabian Style

Liu, Yu-Hsin, 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 et al. 2022. "Hemodialysis Treatment for Patients with Lithium Poisoning" International Journal of Environmental Research and Public Health 19, no. 16: 10044. https://doi.org/10.3390/ijerph191610044

APA Style

Liu, Y.-H., Tsai, K.-F., Hsu, P.-C., Hsieh, M.-H., Fu, J.-F., Wang, I.-K., Liu, S.-H., Weng, C.-H., Huang, W.-H., Hsu, C.-W., & Yen, T.-H. (2022). Hemodialysis Treatment for Patients with Lithium Poisoning. International Journal of Environmental Research and Public Health, 19(16), 10044. https://doi.org/10.3390/ijerph191610044

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