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[Minimal change disease during lithium therapy: case report].

Romina Graziani¹, Mattia Monti¹, Brunilda Sejdiu¹

¹UO Nefrologia e Dialisi, Ospedale Santa Maria delle Croci, Ravenna, Ausl Romagna.

Giornale Italiano Di Nefrologia : Organo Ufficiale Della Societa Italiana Di Nefrologia

|August 3, 2019

Summary

Lithium treatment for bipolar disorder can cause kidney problems. A patient developed nephrotic syndrome and acute kidney injury (AKI) linked to lithium, which resolved after stopping the medication.

Keywords:

lithium minimal change disease nephrotic syndrome

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Area of Science:

Nephrology
Psychiatry
Pharmacology

Background:

Lithium is a cornerstone therapy for bipolar disorder.
Known lithium nephrotoxicity includes diabetes insipidus, metabolic acidosis, and tubulointerstitial nephritis.
A potential link between lithium and minimal change disease has been occasionally reported.

Observation:

A patient with severe bipolar disorder on long-term lithium therapy presented with nephrotic syndrome and acute kidney injury (AKI).
The patient had no prior history of kidney disease.
Renal biopsy revealed histopathologic findings consistent with minimal change disease.

Findings:

Discontinuation of lithium therapy led to the remission of both AKI and nephrotic syndrome.
These clinical and pathological findings strongly suggest lithium-induced minimal change disease.

Implications:

This case highlights a critical, albeit rare, adverse effect of lithium therapy on kidney function.
Clinicians should consider lithium toxicity in patients presenting with unexplained nephrotic syndrome and AKI.
Early recognition and lithium cessation may prevent irreversible kidney damage.