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Statins in the treatment of lithium-induced nephrogenic diabetes insipidus: a pilot randomized controlled trial

Dr. Soham Rej
Lady Davis Institute for Medical Research
Biomedical Research Grants
2017 - 2019
$96,664
Water, salt and calcium handling by the kidney
Lithium is a commonly used treatment in several medical conditions, including bipolar disorder and major depressive disorder. It is also being studied in dementia, stroke, and even cancer. Currently, lithium is used by approximately 350,000 Canadians and more patients could potentially benefit from using it.

However, doctors are avoiding lithium because of chronic kidney disease, which is often irreversible. Lithium exposure can increase the risk of chronic kidney disease by 3 times through Nephrogenic Diabetes Insipidus (NDI), a condition characterized by excessive urination and thirst.

A recent preliminary study found that statins, commonly used cardiovascular medications, are associated with a lower risk of NDI in lithium users, but a randomized clinical trial is needed.

In this first clinical trial, Dr. Soham Rej will test a statin called atorvastatin (Lipitor) in treating NDI in people using lithium. The trial will recruit 60 lithium users, randomly selected to receive either atorvastatin (20mg/day) or placebo for 12 weeks, to observe whether statins can improve NDI.

If successful, this pilot study will generate the information needed to plan future large clinical trials that can confirm whether statins can treat NDI and potentially prevent chronic kidney disease in lithium users. This could improve people's health and prevent the use of costly health services for kidney disease and other medical problems.

This study supports the mission of the Kidney Foundation of Canada by helping reduce the burden of kidney disease through innovation.

Biography

Dr. Soham Rej is a Geriatric Psychiatrist and an Assistant Professor at the Department of Psychiatry, Jewish General Hospital, Lady Davis Institute, McGill University, Montreal, Canada.

His primary research interest has been to understand renal side-effects related to the use of psychotropic medication in older adults. In particular, using pharmacoepidemiology and clinical trial approaches, he has been investigating the risk of nephrogenic diabetes insipidus and chronic kidney disease related to lithium, and approaches to minimizing this risk.

Dr. Soham Rej is also interested in the psychosocial health of patients with chronic kidney disease, including a recently-completed randomized controlled trial examining meditation in the treatment of depression and anxiety in hemodialysis patients.

Dr. Rej is very thankful to the Kidney Foundation of Canada for supporting his research and hopes that his work can improve the lives of Canadians currently dealing with or at future risk for kidney disease.