Comprehensive review on lithium nephrotoxicity: Unravelling pathophysiological mechanisms

Document Type : Review Article

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Department of Pharmacology & Toxicology, Faculty of Pharmacy, Ain Shams University, Cairo, 11566, Egypt

Abstract

Bipolar disorder is commonly treated with lithium. Its toxicity includes hypercalcemia, urine concentration deficit, natriuresis, renal tubular acidosis, and tubulointerstitial nephritis, which aggravates chronic kidney disease. With 20–40% of people experiencing it, diabetes insipidus is the most common adverse effect. A few weeks after therapy starts. The length of lithium usage is correlated with this kind of chronic nephropathy. Lithium accumulates in the collecting renal tubular cells, where it can contribute to tubulointerstitial disease, which can result in localized segmental glomerulosclerosis and the creation of microcystins. This accumulation of lithium is what causes lithium toxicity. The nephrologist and psychiatrist should work together to closely examine patients to discover renal failure early.

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