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Updated: May 23, 2026
03:19
Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition
Published on: June 21, 2024
Lithium nephropathy: unique sonographic findings
Donald N Di Salvo1, Joseph Park, Faye C Laing
1Division of Ultrasound Services, Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA. ddisalvo@partners.org
Summary
Chronic lithium therapy can cause unique kidney changes. Sonography reveals microcysts and echogenic foci, suggesting lithium nephropathy in patients with kidney issues.
Area of Science:
- Nephrology
- Radiology
- Pharmacology
Background:
- Lithium is a common mood stabilizer for bipolar disorder.
- Long-term lithium use is associated with various renal complications.
- Early detection of lithium-induced kidney damage is crucial for management.
Purpose of the Study:
- To describe the characteristic sonographic findings in patients with chronic lithium therapy.
- To correlate sonographic findings with clinical presentation and other imaging modalities.
- To propose sonography as a diagnostic tool for lithium nephropathy.
Main Methods:
- Retrospective case series of 10 adult patients on chronic lithium therapy.
- Renal sonography was performed on all patients.
- Computed tomography (CT) and magnetic resonance imaging (MRI) were used in select cases.
- Renal biopsy was performed in one patient for histological confirmation.
Main Results:
- Sonography revealed numerous microcysts and punctate echogenic foci in all 10 patients.
- Chronic renal insufficiency was present in 6 patients; nephrogenic diabetes insipidus in 2.
- CT confirmed microcysts and microcalcifications; MRI confirmed microcysts.
- Renal biopsy showed chronic interstitial nephritis, microcysts, and tubular dilatation.
Conclusions:
- A unique sonographic pattern of microcysts and punctate echogenic foci is associated with chronic lithium therapy.
- These sonographic findings, when present, should raise suspicion for lithium nephropathy.
- Sonography may aid in the early diagnosis and monitoring of lithium-induced kidney disease.
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