title: Lithium in the Kidney: Friend and Foe?
abstract: Trace amounts of lithium are essential for our physical and mental health, and administration of lithium has improved the quality of life of millions of patients with bipolar disorder for >60 years. However, in a substantial number of patients with bipolar disorder, long-term lithium therapy comes at the cost of severe renal side effects, including nephrogenic diabetes insipidus and rarely, ESRD. Although the mechanisms underlying the lithium-induced renal pathologies are becoming clearer, several recent animal studies revealed that short-term administration of lower amounts of lithium prevents different forms of experimental AKI. In this review, we discuss the knowledge of the pathologic and therapeutic effects of lithium in the kidney. Furthermore, we discuss the underlying mechanisms of these seemingly paradoxical effects of lithium, in which fine-tuned regulation of glycogen synthase kinase type 3, a prime target for lithium, seems to be key. The new discoveries regarding the protective effect of lithium against AKI in rodents call for follow-up studies in humans and suggest that long-term therapy with low lithium concentrations could be beneficial in CKD.
authors.affiliation: Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands; and.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Alsady
authors.affiliation: Vivium Care Group, Huizen, The Netherlands.
authors.forename: Ruben
authors.initials: R
authors.lastname: Baumgarten
authors.affiliation: Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands; and.
authors.forename: Peter M T
authors.initials: PM
authors.lastname: Deen
authors.affiliation: Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands; and theun.degroot@Radboudumc.nl.
authors.forename: Theun
authors.initials: T
authors.lastname: de Groot
mesh_terms: D000818:Animals; D001714:Bipolar Disorder / Q000188:drug therapy; D018500:Diabetes Insipidus, Nephrogenic / Q000139:chemically induced; D004195:Disease Models, Animal; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced*; D007676:Kidney Failure, Chronic / Q000139:chemically induced; D018020:Lithium Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy*
chemical_list: D018020:Lithium Compounds
keywords: acute renal failure; cell and transport physiology; cell signaling; diabetes insipidus; drug nephrotoxicity; end-stage renal disease