title: Severe hypernatraemia due to nephrogenic diabetes insipidus - a life-threatening side effect of chronic lithium therapy.
abstract: Renal toxicity of long-term lithium therapy is a common problem. Nephrogenic diabetes insipidus is the most frequently encountered complication, but often remains unrecognised because of the rather benign symptoms. We present a patient with long-term lithium therapy who developed life-threatening hypernatraemia due to insufficient oral fluid intake after elective spinal surgery. Careful daily substitution of up to 25 l of hypotonic fluids led to full recovery within 9 days. Nephrogenic diabetes insipidus should always be considered in lithium-treated patients undergoing elective surgery in order to avoid severe hypernatraemia.
authors.affiliation: Division of Endocrinology and Diabetes, Department of Internal Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland. lisa.sze@bluewin.ch
authors.forename: L
authors.initials: L
authors.lastname: Sze
authors.forename: B
authors.initials: B
authors.lastname: Ulrich
authors.forename: M
authors.initials: M
authors.lastname: Brändle
mesh_terms: D003919:Diabetes Insipidus / Q000139:chemically induced* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006955:Hypernatremia / Q000209:etiology*; D007405:Intervertebral Disc Displacement / Q000601:surgery; D016651:Lithium Carbonate / Q000009:adverse effects*; D008875:Middle Aged; D012562:Schizophrenia, Disorganized / Q000188:drug therapy
chemical_list: D016651:Lithium Carbonate