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

In a retrospective cohort study,1 and by contrast with their previous report,2 Brian Shine and colleagues showed that lithium use was associated with an increased risk of stage 3 chronic kidney disease, which was more likely to occur in women, early in treatment course, and with higher plasma lithium concentrations. Although the investigators were able to collect data on a large number of patients, they were unfortunately burdened by biases that cast uncertainty on interpretation of the results.