Severe hypernatraemia due to nephrogenic diabetes insipidus - a life-threatening side effect of chronic lithium therapy.
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.
Sze
L
L
Division of Endocrinology and Diabetes, Department of Internal Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland. lisa.sze@bluewin.ch
Ulrich
B
B
Brändle
M
M
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
D016651:Lithium Carbonate