URINARY-EXCRETION OF ALBUMIN AND TRANSFERRIN IN LITHIUM MAINTENANCE TREATMENT - DAILY VERSUS ALTERNATE-DAY LITHIUM DOSING SCHEDULE

Urinary excretion of albumin and transferrin was determined by means o f sensitive immunochemical methods in 40 manic-depressive patients pri or to and following 6 months of daily or alternate-day lithium carbona te treatment. The median dose of lithium carbonate was 700 mg in the d aily treatment group and 1200 mg in the alternate-day group, the corre sponding median 12-h serum lithium concentration being 0.6 mmol l(-1) and 0.7 mmol l(-1), respectively. Urinary excretion of albumin and tra nsferrin was significantly elevated in the lithium-treated patients as compared to a control group (Mann-Whitney). The change in urinary alb umin:creatinine and transferrin:creatinine ratios between allocation a nd 6 months of treatment did not correlate significantly with the lith ium dosing schedule (multiple linear regression), but did correlate wi th total lithium carbonate dose. In conclusion, the study provides no evidence of any difference in glomerular function (permeability) in th e daily and alternate-day lithium dosing schedules, and lends no suppo rt to the hypothesis that alternate-day treatment diminishes the effec t of lithium on renal function.