Tudosie M.S. 1, 2, Păun S.C. 1, M. Ionică 2, Luminiţa Ardelean 1, Viorica Bumbea 3, Ciupan R. 4, Mureşan A. 5, Mladin C. 6
1 University of Medicine and Pharmacy “Carol Davila” Bucharest
2 Army Center of Medical Research Bucharest,
3 Emergency Hospital Bucharest,
4 Emergency Hospital “Agripa Ionescu” Bucharest,
5 Centre Hôspitalier Universitaire Amiens – France,
6 Mecro System Bucharest
Abstract
Lithium belongs to the class of toxic elements. The maximum value permitted in blood is 3 μg/l, and 500 μg/l in urine [12]. Salt form is used as an antidepressant. There were analyzed blood samples collected from a sample of 50 subjects with normal renal function (creatinine <1.5 mg/dl), considered the control group, the average of creatinine being 0.99 mg/dl. The study group consisted of 50 patients with chronic renal disease. Blood samples were taken before and after dialysis and dialysis fluid samples, taken 0.5, 1, 2, 3, and 4 hours after, recorded with LD1 … 5 . From samples taken from both groups, concentration of lithium was determined. The authors also present the analytical technique based on atomic absorption spectrometry for determination of lithium in the samples mentioned above. Control group average was 0.42 μg/dl with values raging from 0 to 2.7 μg/dl. Study group average was 3.29 μg / dl before and 1.58 μg/dl after dialysis. The averages of the five times of elimination of lithium in the dialysate were LD1 = 13.85, = 14.81 LD2, LD3 = 12.85, LD4 and LD5 = 15,308 = 13.46 μg/l. The study includes analysis of lithium concentration by gender. Average clearance of lithium elimination during dialysis was 10.78 μg/min and total elimination average during the dialysis session was 2.59 mg. Student Test applied to the two groups both at coupling and at return does not differ, statistically speaking, significantly from the average of the control group. Given the small amount of lithium removed during a dialysis session, special attention should be paid to the potential antidepressant treatment based on lithium due to risk of accumulation and hence occurrence of iatrogenic acute poisoning.