Acute and chronic effects of lithium on the kidney

Abstract

Lithium is commonly used in the treatment of bipolar disorders. Acute and chronic lithium toxicity remains a serious drawback; however, lithium efficacy and the absence of other therapeutic alternatives make this drug irreplaceable. Chronic renal failure due to tubulo-interstitial toxicity is poorly reversible. Nephrogenic diabetes insipidus is also a consequence of chronic lithium treatment that may persist despite drug discontinuation. Renal dysfunction favors acute lithium poisoning. Extracellular volume depletion stimulates lithium tubular reabsorption, and consequently results in lithium accumulation. Recent data led to a better understanding of the renal consequences of lithium treatment.