Lithium Dosing Schedule and Renal Insufficiency

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Sir: Lepkifker et al.¹ performed a valuable service by providing long-term renal follow-up data on a sizable cohort of patients on lithium treatment from 4 to 30 years. Despite the long-standing controversy regarding lithium’s effects on renal function, to my knowledge, no study of lithium’s renal effects has had 30-year follow-up data. I commend their work. However, I wonder whether their unique cohort could be used to shed further light on more specific questions of how to manage lithium to minimize the risk of renal effects.’ ‹’ ‹