Prediction of Lithium Dose Requirement: Comparison of Renal Lithium Clearance and Serum Lithium Estimation

2015 ◽  
pp. 172-181
Author(s):  
S. P. Tyrer ◽  
M. Kalvar ◽  
B. Shopsin ◽  
P. Grof
Keyword(s):  
Lithium Clearance ◽  
Dose Requirement ◽  
Lithium Dose

Estimation of lithium dose requirement by body weight

2002 ◽  
Vol 4 (4) ◽  
pp. 274-274 ◽  
Author(s):  
Mong-Liang Lu ◽  
Winston W Shen ◽  
Kun-Po Chen
Keyword(s):  
Body Weight ◽  
Dose Requirement ◽  
Lithium Dose

Increased Lithium Dose Requirement in a Hyperglycemic Patient

2002 ◽  
Vol 36 (3) ◽  
pp. 427-429 ◽  
Author(s):  
Monica Cyr ◽  
Melanie AC Guia ◽  
S Casey Laizure
Keyword(s):  
Blood Glucose ◽  
Plasma Concentration ◽  
Glucose Concentration ◽  
Blood Glucose Concentration ◽  
Plasma Concentrations ◽  
Dose Requirement ◽  
Lithium Plasma ◽  
Blood Glucose Concentrations ◽  
Persistent Hyperglycemia ◽  
Lithium Dose

OBJECTIVE: To report a case of apparent increased lithium clearance in a patient with persistent hyperglycemia. METHODS: Lithium doses, blood glucose concentrations, and lithium plasma concentrations were evaluated in a patient during a 53-day inpatient admission for exacerbation of bipolar disorder. The lithium dose required to increase the lithium plasma concentration by 0.1 mEq/L was computed from the lithium dose and corresponding lithium plasma concentration. This value was correlated with the blood glucose concentration. RESULTS: A plot of the lithium dose required to increase the lithium plasma concentration by 0.1 mEq/L versus the blood glucose concentration exhibited a direct linear relationship (r2 = 0.62). This plot indicates that higher lithium doses are needed during hyperglycemic states compared with euglycemic states to achieve equivalent plasma concentrations. CONCLUSIONS: Glycosuria associated with hyperglycemia induces an osmotic diuresis that increases the renal clearance of lithium, necessitating higher lithium doses to maintain therapeutic lithium plasma concentrations.

Dose Requirement for Replacement Therapy in Hemophilia A

1979 ◽  
Vol 42 (03) ◽  
pp. 825-831 ◽  
Author(s):  
Jean-Pierre Allain
Keyword(s):  
Clinical Effect ◽  
Hemophilia A ◽  
Clinical Results ◽  
Severe Hemophilia ◽  
Dose Requirement ◽  
Viii Level ◽  
The Relationship ◽  
In Vivo Recovery ◽  
Different Doses

SummaryIn order to determine the correlation between different doses of F. VIII and their clinical effect,. 70 children with severe hemophilia A were studied after treatment with single doses of cryoprecipitate. The relationship between plasma F. VIII levels or doses calculated in u/ kg of body weight and clinical results followed an exponential curve. Plasma F. VIII levels of 0.35 and 0.53 u/ml corresponded to 95 and 99% satisfactory treatment, respectively. Similar clinical results were obtained with 20 and 31 u/kg. When the in vivo recovery of F. VIII after lyophilized cryoprecipitate was 0.015 u/ml for each u/kg injected, plasma F. VIII levels of 0.30 and 0.47 u/ml respectively were achieved. Since home treatment is largely based on single infusions of F. VIII, it is suggested that moderate and severe hemorrhages be treated with a dose which will provide a plasma F. VIII level of 0.5 u/ml.

Changes in glomerular filtration rate, lithium clearance and plasma protein clearances in the early phase after unilateral nephrectomy in living healthy renal transplant donors

1988 ◽  
Vol 75 (6) ◽  
pp. 655-659 ◽  
Author(s):  
S. Strandgaard ◽  
A. Kamper ◽  
P. Skaarup ◽  
N. H. Holstein-Rathlou ◽  
P. P. Leyssac ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Plasma Protein ◽  
Immunoglobulin G ◽  
Filtration Rate ◽  
Early Response ◽  
Unilateral Nephrectomy ◽  
Lithium Clearance ◽  
Β2 Microglobulin ◽  
Observation Period

1. Glomerular and tubular function was studied before and 2 months after unilateral nephrectomy in 14 healthy kidney donors by measurement of the clearances of 51Cr-labelled ethylenediaminetetra-acetate, lithium, β2-microglobulin, albumin and immunoglobulin G. 2. The glomerular filtration rate (GFR) of the kidney that remained in the donor rose from 45 ± 10 (mean ± sd) to 59 ± 10 ml/min (P < 0.01) 5 days after contralateral nephrectomy and remained at this level through the observation period. 3. The lithium clearance (CLi) of the remaining kidney rose from 11.6 ± 3.7 to 20.5 ± 8.2 ml/min (P < 0.01) and remained significantly elevated throughout the observation period. 4. Absolute proximal fluid reabsorption rate (APR), which was estimated as GFR minus CLi, was unchanged 5 days after contralateral nephrectomy, but then rose gradually to reach significantly elevated levels after 4 weeks. 5. Fractional proximal reabsorption (FPR; APR/GFR) fell from 0.75 ± 0.06 to 0.66 ± 0.11 (P < 0.01) but subsequently rose to levels not significantly decreased from normal. 6. Twenty-four hour fractional clearances of β2-microglobulin, albumin and immunoglobulin G rose markedly on the day of nephrectomy, peaked at 2–3 days and subsequently fell to moderately elevated levels. 7. Both the CLj and the plasma protein clearance studies demonstrate that the early response of the remaining kidney to contralateral nephrectomy in man is an increase in GFR, an unchanged APR and a fall in FPR. The proximal tubules thus initially handle the increased filtrate load by passing it on to more distal nephron segments. Within 2–4 weeks, an adaptive increase is seen in proximal reabsorption of both protein and fluid, resulting in an almost complete normalization of glomerulotubular balance.

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