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Reversible Nephrogenic Diabetes Insipidus Induced by Lithium: A Case Report
Sevil Uygun İlikhan1, Gülin Dilken1, Gökhan Hazıroğlu1
1Department of Internal Medicine, Ankara Bilkent City Hospital, Ankara, Turkey.
Case Reports in Nephrology
|April 8, 2026
Summary
Lithium therapy can cause nephrogenic diabetes insipidus (NDI), impairing kidney function. This case shows NDI can be managed by discontinuing lithium and using thiazides, allowing urinary concentrating ability to recover.
Area of Science:
- Nephrology
- Endocrinology
- Pharmacology
Background:
- Lithium is a crucial mood stabilizer.
- Long-term lithium use can lead to nephrogenic diabetes insipidus (NDI) by affecting the kidneys' response to arginine vasopressin (AVP).
- NDI is characterized by impaired urinary concentrating ability.
Purpose of the Study:
- To report a case of lithium-induced NDI.
- To highlight the diagnostic and management strategies for NDI in a patient on long-term lithium therapy.
- To demonstrate the potential for recovery of renal function after lithium discontinuation.
Main Methods:
- A case report of a 52-year-old woman with symptoms of NDI.
- Clinical evaluation including serum electrolytes, osmolality, urine output, and lithium levels.
- Management involved fluid replacement, electrolyte correction, lithium discontinuation, and thiazide therapy.
Main Results:
- The patient presented with hypernatremia, polyuria, and low urine osmolality.
- Renal function was preserved despite high lithium levels.
- Discontinuation of lithium and initiation of thiazides led to normalization of serum sodium, reduced urine output, and full mental recovery within 72 hours.
Conclusions:
- Lithium-induced NDI is a reversible condition.
- Prompt diagnosis and management, including lithium cessation and thiazide treatment, can restore kidney concentrating ability.
- This case underscores the importance of recognizing and treating NDI to prevent long-term complications.
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