Nephropathy after long term lithium therapy – case report
Keywords:
lithium, kidneys, nephropathyAbstract
Lithium is widely used to treat bipolar disorder. The aim of the paper was to present a problem of lithium-induced nephropathy. The adverse renal effects of long term lithium therapy include nephrogenic diabetes insipidus,acute renal insufficiency and chronic renal disease. Screening test suggested to catch the beginning of renal function abnormalities in patients undergoing long-term lithium therapy are the analysis of urine (specific gravity, protein), serum creatinine, GFR, blood pressure, ultrasound / CT (renal microcysts). Our case study shows that a rapid increase of lithium level in the blood, despite use of the same dose is predictor of developing chronic kidney disease.
References
1. Lederer E. Lithium Nephropathy. Medscape, 2012;1
2. Rzewuska M. Leczenie zaburzeń psychicznych. Warszawa; PZWL: 2006, s.42-43.
3. Bazire S. Przewodnik leków psychotropowych 2010, Gdańsk; Viamedica: 2012, s.43-44.
4. Strzelecki D. Przewodnik psychofarmakoterapii. Działanie niepożądane i powikłania. Gdańsk; Viamedica: 2011, s.59-60, 227-229.
5. Grunfeld J.P., Bernard C., Rossier J. Lithium nephrotoxicity revisited. Nature Reviews Nephrology, 2009; 5:270-276.
6. Rybakowski J., Drogowska J., Abramowicz M., Chłopocka-Woźniak M., Czekalski S. Wpływ długotrwałego podawania litu na czynność nerek. Psychiatria Polska, 2012; 4:627-636.
7. Freeman M.P., Freeman S.A. Lithium clinical consideration in internal medicine. AM. J. Med., 2006; 119:478-481.
8. Tredget J., Kirov A., Kirov G. Effect of chronic lithium treatment of renal function. J. Affect. Disord., 2010; 126:436-440.
9. Boton R., Gaviria M., Batlle D.C. Prevelance, pathogenesis and treatment of renal dysfunctions associated with cgronic lithium therapy. Medline, 1987; 11.
10. Bendz, Aurell, Balldin, Mathe.Kidney damage in long-term lithium patients: a cross-sectional study of patients with 15 years or more on lithium. Nephrol. Dial. Transplant, 1994; 9:1250-1254.
11. Markovitz G.S., Radhakrishnan J., Kambhan N., Valeri A.M., Hines W.H., D'Agati V.D. Lithium Nephrotoxicity: A Progressive Combined Glomerular and Tubulointerstitial Nephropathy. J Am Soc Nephrol, 2000; 11:1439-1448.
12. Perera E., Bhatt S., Dogra V. University of Rochester. Lithium Nephropathy. Imaginista science today, 2010; 11:2388.
13. Farres M.T., Ronco P., Saadoun D., Remy P., Vincent F., Le Blanche A. Chronic Lithium Nephropathy: MR Imaging for Diagnosis. Radiology, 2003; 229:570-574.
