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Additionally, we aimed to investigate the association between the duration of lithium treatment and the risk of CKD4\u2009+\u2009.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We identified patients from the Sahlgrenska University Hospital\u2019s laboratory database. We conducted a retrospective cohort study employing cumulative incidence functions that account for competing deaths to estimate cumulative and lifetime risk of CKD4\u2009+\u2009. A subdistribution hazards model was employed to explore baseline covariates. For measuring the association between the duration of lithium treatment and CKD4\u2009+\u2009occurrence, we used a matched 1:4 case\u2013control study design and logistic regression.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Considering a 90-year lifetime horizon, the lifetime risk of CKD4\u2009+\u2009for patients initiating lithium treatment between ages 55 and 74 ranged from 13.9% to 18.6%. In contrast, the oldest patient group, those starting lithium at 75 years or older, had a lower lifetime risk of 5.4%. The 10-year cumulative risk for patients starting lithium between ages 18 and 54 was minimal, ranging from 0% to 0.7%. Pre-treatment creatinine level was a predictive factor, with a hazard ratio of 4.6 (95% CI 2.75\u20137.68) for values within the upper third of the reference range compared to the lower third. Moreover, twenty or more years of lithium exposure showed a strong association with an increased risk of CKD4\u2009+\u2009compared to 1\u20135 years of lithium use, with an odds ratio of 6.14 (95% CI 2.65\u201314.26).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The risk of CKD4\u2009+\u2009among lithium-treated patients exhibited significant age-related differences. Patients under 55 years old had negligible 10-year risk, while the lifetime risk for those aged 75 and older was limited. Duration of lithium treatment, especially exceeding 20 years, emerged as a significant risk factor. For individual risk assessment and prediction, consideration of age, pre-treatment creatinine levels, and the chosen time horizon for prediction is essential.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40345-023-00319-2","type":"journal-article","created":{"date-parts":[[2023,12,9]],"date-time":"2023-12-09T10:02:24Z","timestamp":1702116144000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Lifetime risk of severe kidney disease in lithium-treated patients: a retrospective study"],"prefix":"10.1186","volume":"11","author":[{"given":"Mihaela","family":"Golic","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Aiff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per-Ola","family":"Attman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Ramsauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Staffan","family":"Sch\u00f6n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steinn","family":"Steingrimsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Svedlund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,12,9]]},"reference":[{"issue":"4","key":"319_CR1","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1016\/j.euroneuro.2014.01.002","volume":"24","author":"H Aiff","year":"2014","unstructured":"Aiff H, Attman PO, Aurell M, Bendz H, Sch\u00f6n S, Svedlund J. 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