Lithium in chronic renal failure: a case report

Area of Science:

• Nephrology
• Psychiatry
• Pharmacology

Background:

• Lithium is a cornerstone treatment for bipolar disorder.
• Long-term lithium therapy is associated with nephrotoxicity and chronic renal failure.
• Managing bipolar disorder while mitigating lithium-induced renal complications presents a clinical challenge.

Observation:

• A 73-year-old female patient with bipolar disorder developed chronic renal failure after long-term lithium treatment.
• Alternative treatments were unsuccessful, leading to a diminished quality of life and frequent hospitalizations.
• The patient expressed a clear wish and demonstrated capacity to consent to restarting lithium therapy.

Findings:

• The case highlights the complex decision-making process when a critical medication causes significant side effects.
• Reintroducing lithium, despite previous renal complications, was deemed necessary to improve the patient's quality of life.
• This underscores the importance of individualized patient care and shared decision-making.

Implications:

• This case provides insights into managing lithium-induced chronic renal failure in bipolar disorder patients.
• It emphasizes the need for careful risk-benefit assessment and patient-centered management strategies.
• Clinicians should consider patient preferences and capacity when treatment options are limited.