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Sir: I read the recent article by Lepkifker et al.1 on renal insufficiency in long-term lithium treatment with interest. This retrospective study compared renal functioning (with renal insufficiency operationally defined as blood creatinine levels ≥ 1.5 mg/dL) in 114 subjects with bipolar, major depressive, or schizoaffective disorder on lithium treatment with an ageand sex-matched unmedicated control group of 94 subjects. The duration of lithium treatment ranged from 4 to 30 years (mean = 16.75 years, SD = 7.89).’ ‹