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[Correspondence] Long-term effects of lithium on renal function

The Article by Brian Shine and colleagues1 is the best accounting of the long-term adverse effects associated with lithium treatment that has ever been published, and the authors deserve high praise. However, like all strong studies, it answers some questions and poses others. For instance, the analysis suggests that male patients younger than 60 years will have almost no greater decline in renal function than control patients for more than 20 years of treatment (figure 3).1 But this conclusion might inadvertently combine the effects of lithium treatment duration and age.