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2015 ; 3
(1
): 28
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Lithium nephrotoxicity
#MMPMID26043842
Azab AN
; Shnaider A
; Osher Y
; Wang D
; Bersudsky Y
; Belmaker RH
Int J Bipolar Disord
2015[Dec]; 3
(1
): 28
PMID26043842
show ga
Reports of toxic effects on the kidney of lithium treatment emerged very soon
after lithium therapy was introduced. Lithium-induced nephrogenic diabetes
insipidus is usually self-limiting or not clinically dangerous. Some reports of
irreversible chronic kidney disease and renal failure were difficult to attribute
to lithium treatment since chronic kidney disease and renal failure exist in the
population at large. In recent years, large-scale epidemiological studies have
convincingly shown that lithium treatment elevates the risk of chronic kidney
disease and renal failure. Most patients do not experience renal side effects.
The most common side effect of polyuria only weakly predicts increasing
creatinine or reduced kidney function. Among those patients who do experience
decrease in creatinine clearance, some may require continuation of lithium
treatment even as their creatinine increases. Other patients may be able to
switch to a different mood stabilizer medication, but kidney function may
continue to deteriorate even after lithium cessation. Most, but not all, evidence
today recommends using a lower lithium plasma level target for long-term
maintenance and thereby reducing risks of severe nephrotoxicity.
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