CHRONIC INTERSTITIAL NEPHROPATHY IN PATIENTS ON LONG-TERM LITHIUM TREATMENT

  • 1 January 1979
    • journal article
    • research article
    • Vol. 48  (192) , 577-591
Abstract
Patients [110] treated with Li [psychopharmacological agent] for more than 6 mo. were studied to determine the prevalence of Li induced nephropathy. Of 69 patients (26%) who had been treated for more than 2 yr, 18 presented a chronic interstitial nephropathy characterized by a marked decrease in renal concentrating ability with a disproportionate preservation of glomerular filtration rate. Histologically, increased amounts of fibrotic tissue in the medulla and the cortex were found together with tubular atrophy. In 40% of the patients who underwent renal biopsy, cystic formations in the cortex were found. The impairment of renal concentrating ability could be related to the duration of Li treatment and the degree of tubular damage correlated with the degree of impairment of renal concentrating ability. Li induced, chronic nephropathy is a rather common complication of long-term Li treatment and reduces the patient''s capacity to regulate water and electrolyte metabolism. As water and electrolyte loss appears to precede the slowly progressing Li intoxication, the main hazard of Li induced nephropathy is Li intoxication.