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Lithium and the antidiuretic hormone

S MacNeil, G Jennings, P R Eastwood

    British Journal of Clinical Pharmacology
    |April 1, 1976
    PubMed
    Summary
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    Lithium impairs the kidney's response to antidiuretic hormone (ADH), reducing urine concentration. It also increases ADH excretion, potentially explaining lithium-induced changes in water balance.

    Area of Science:

    • Nephrology
    • Endocrinology
    • Pharmacology

    Background:

    • Lithium is a common treatment for bipolar disorder.
    • Lithium is known to cause polyuria and polydipsia in some patients.
    • The precise mechanisms underlying lithium's effects on renal water handling are not fully understood.

    Purpose of the Study:

    • To investigate the impact of lithium on the renal response to antidiuretic hormone (ADH).
    • To examine the effect of lithium on ADH excretion in humans and rats.

    Main Methods:

    • Assessed maximum urine osmolarity after dehydration and exogenous ADH (Pitressin) administration in patients with and without lithium treatment.
    • Measured 24-hour ADH excretion in non-polyuric patients during lithium therapy.
    • Administered clorexolone to patients with lithium-induced polyuria.

    Related Experiment Videos

  • Studied urine volume and ADH excretion in rats fed a lithium-containing diet.

    • Main Results:

    • Lithium treatment decreased maximum urine osmolarity in three out of four patients.
    • One patient on lithium showed hypotonic urine throughout the test.
    • Lithium significantly increased ADH excretion in non-polyuric patients (from 9-22 μg/24h to 36-202 μg/24h).
    • Clorexolone reduced polyuria in patients with lithium-induced polyuria.
    • Lithium increased urine volume and ADH excretion in rats.
    • The kidney's response to exogenous ADH was diminished during lithium administration.

    Conclusions:

    • Lithium impairs the kidney's ability to concentrate urine in response to ADH.
    • Lithium increases ADH excretion, suggesting a complex effect on the body's water regulation system.
    • These findings help elucidate the mechanisms of lithium-induced nephrogenic diabetes insipidus and polyuria.