title: [Renal side effects of long-term lithium therapy].
abstract: Lithium is widely used in the treatment of bipolar disorders. Long-term administration of lithium often leads to side effects concerning the subjects: nephrology, endocrinology and surgery. This review emphasizes nephrotoxicity.Lithium treatment may disturb responsiveness to antidiuretic hormone (ADH), causing a nephrogenic diabetes insipidus. Furthermore long-term lithium therapy may trigger hyperparathyreoidism with hypercalcemia and chronic interstitial nephritis with development of microcysts. Long-term patients have an increased risk to develop impaired renal function. Lithium-induced endstage renal disease is rare. Termination of lithium treatment may decrease the risk of progression.To ensure security of lithium treatment regular controls of urine osmolarity, lithium-, creatinine- , thyroid stimulating hormone- and calcium-levels are essential. Patients with decreased renal function should be referred to a specialist early.
authors.affiliation: Medizinische Klinik, St. Franziskus Hospital Münster, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Ibbeken
authors.forename: J U
authors.initials: JU
authors.lastname: Becker
authors.forename: M W
authors.initials: MW
authors.lastname: Baumgärtel
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018692:Antimanic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001284:Atrophy / Q000139:chemically induced; D001714:Bipolar Disorder / Q000188:drug therapy; D018500:Diabetes Insipidus, Nephrogenic / Q000139:chemically induced; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced / Q000150:complications; D006961:Hyperparathyroidism / Q000139:chemically induced / Q000150:complications; D007668:Kidney / Q000187:drug effects*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000473:pathology; D007684:Kidney Tubules / Q000473:pathology; D018020:Lithium Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000139:chemically induced / Q000150:complications
chemical_list: D000928:Antidepressive Agents; D018692:Antimanic Agents; D018020:Lithium Compounds