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[Lithium and water metabolism]

C J Chaccour, L F Gayral, E Goldberger

    L'Encephale
    |January 1, 1977
    PubMed
    Summary

    Lithium (Li+) can impair kidney function, frequently causing urinary concentration issues in 50% of patients, even without overt symptoms. These subtle effects highlight the need for careful monitoring during lithium therapy for manic-depressive illness.

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    Area of Science:

    • Nephrology
    • Endocrinology
    • Pharmacology

    Context:

    • Lithium therapy is common for manic-depressive illness.
    • Water balance disturbances are potential side effects.
    • Previous studies have shown varied results on lithium's impact on water metabolism.

    Purpose:

    • To investigate the interaction between lithium (Li+) and water balance in patients with manic-depressive illness.
    • To identify subclinical urinary concentration abnormalities induced by lithium.
    • To explore the diurnal variations in renal lithium clearance.

    Summary:

    • Lithium induced nephrogenic diabetes insipidus in one of nine patients.
    • Four patients showed impaired urinary concentration, responsive to ADH (antidiuretic hormone).
    • Fifty percent of patients experienced subclinical urinary concentration defects, detectable only through biological tests, with both nephrogenic and central origins.
    • Renal lithium clearance decreased after dehydration and increased after water loading, with a notable circadian rhythm.

    Impact:

    • Lithium frequently causes subclinical urinary concentration defects, necessitating biological monitoring.
    • The findings suggest a dual origin (nephrogenic and central) for lithium-induced water metabolism disturbances.
    • A novel methodology revealed a circadian rhythm in renal lithium clearance, potentially impacting lithium therapy practices.

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