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Nephrotic syndrome associated with lithium therapy

F Alexander, J Martin

    Clinical Nephrology
    |May 1, 1981
    PubMed
    Summary

    Long-term lithium therapy can cause nephrotic syndrome in patients. Withdrawal of lithium effectively treated the condition, highlighting its renal toxicity.

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    Area of Science:

    • Nephrology
    • Pharmacology

    Background:

    • Lithium is a common mood stabilizer for bipolar disorder.
    • Lithium is known to cause acute renal failure and tubulo-interstitial disease.
    • The association between lithium and nephrotic syndrome is not widely recognized.

    Observation:

    • Two patients on long-term lithium therapy presented with nephrotic syndrome.
    • Renal biopsy revealed extensive glomerular epithelial cell foot process fusion in both patients.

    Findings:

    • Lithium withdrawal led to the resolution of nephrotic syndrome in both patients without steroid therapy.
    • In one patient who resumed lithium, nephrotic syndrome recurred with more severe glomerular lesions, resolving again upon lithium withdrawal and steroid treatment.
    • This suggests a direct link between lithium exposure and the development of nephrotic syndrome.

    Implications:

    • Clinicians should consider lithium toxicity in patients developing nephrotic syndrome.
    • Monitoring renal function and screening for proteinuria in patients on long-term lithium therapy is crucial.
    • This study expands the understanding of lithium's potential adverse renal effects beyond acute failure and tubulo-interstitial disease.

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