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[Impaired kidney function in lithium therapy]

L Gabutti1, M Gugger, H P Marti

  • 1Departement Innere Medizin, Inselspital Bern.

Therapeutische Umschau. Revue Therapeutique
|October 28, 1998
PubMed
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Long-term lithium therapy can cause kidney damage, most commonly nephrogenic diabetes insipidus, a condition where kidneys resist antidiuretic hormone. This review discusses lithium

Area of Science:

  • Nephrology
  • Pharmacology

Background:

  • Lithium is a mood stabilizer used for long-term psychiatric treatment.
  • Long-term lithium use is associated with various renal side effects.

Observation:

  • Nephrogenic diabetes insipidus (NDI) is the most prevalent side effect, affecting 20-70% of patients.
  • NDI results from lithium-induced resistance of renal collecting ducts to antidiuretic hormone.
  • Other functional disturbances include renal tubular acidosis and hypercalcemia-related issues.

Findings:

  • Structural kidney alterations are less common but include chronic tubulo-interstitial nephritis, acute tubular necrosis, and rare glomerulopathies.
  • The case report details chronic interstitial nephritis.
  • Lithium nephrotoxicity presents a diverse clinical picture.

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Implications:

  • Understanding lithium's nephrotoxicity is crucial for managing patients on long-term therapy.
  • Monitoring renal function is essential to prevent or mitigate adverse effects.
  • Further research may elucidate mechanisms and improve therapeutic strategies.