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Lithium-induced nephrotic syndrome
I K Wood1, D X Parmelee, J W Foreman
1Division of Child Psychiatry, Virginia Treatment Center for Children, Richmond.
The American Journal of Psychiatry
|January 1, 1989
Summary
Lithium treatment can cause nephrotic syndrome, a rare kidney condition, even at normal doses. This condition, characterized by minimal change disease, often resolves after stopping lithium.
Area of Science:
- Nephrology
- Pharmacology
- Toxicology
Background:
- Lithium is a mood stabilizer used to treat bipolar disorder.
- Nephrotic syndrome is a kidney disorder characterized by protein in the urine.
- Adverse renal effects of lithium are uncommon but can be serious.
Observation:
- Lithium-induced nephrotic syndrome is a rare, idiosyncratic adverse renal effect.
- It can occur at therapeutic plasma lithium levels.
- Renal biopsies show fusion of foot processes of renal epithelial cells (minimal change disease).
Findings:
- The syndrome is typically reversible upon lithium discontinuation, though corticosteroids may be needed.
- No specific risk factors identify individuals prone to developing this condition.
- This review includes eight previously published cases and one new case of lithium-induced nephrotic syndrome in an adolescent.
Implications:
- Clinicians should be aware of the potential for lithium-induced nephrotic syndrome.
- Early recognition and discontinuation of lithium are crucial for management.
- Further research may be needed to identify individuals at risk.