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Side Effects of Lithium: Kidneys

Lithium has been a standby medication for bipolar disorder for decades. Lithium salts are toxic to the kidneys, causing several various syndromes including acute renal failure, which is highly fatal and mostly irreversible in patients even upon admittance to a hospital. Other lithium disorders can be treated, prolonging the patients' lives. Most other syndromes are related to renal failure in one way or another, the only difference being the salt's interaction with the kidneys.

  1. Acute Renal Failure

    • Acute renal failure occurs with high doses of lithium or lithium intoxication. In this instance, the lithium salts in the kidney lead to rapid urination and hydration since the salts cause the kidney to be unable to hold water any longer. In this case, acute renal failure patients usually die within 8 days of the onset, whereas with chronic lithium usage, the kidney slowly loses function, but the patients have a higher survival rate.

    NDI

    • Chronic use of Lithium may cause nephrogenic diabetes insipidus, or NDI, a condition in which the kidneys are unable to "conserve water." The main symptoms are excreting large amounts of dilute urine called polyuria and drinking large amounts of water, or polydipsia, to make up for the urine being rapidly excreted from the kidneys. Severe dehydration takes effect when the patient cannot drink enough water to make up for the water and urine excreted by the kidneys. In some cases, blood plasma gets too high in response to the hydration. If this complication goes and comes in rapid cycles or becomes a chronic condition, permanent brain damage may occur.

    RTA

    • RTA, or renal tubular acidosis, can be a complication of chronic lithium use. This occurs when the kidneys are unable to excrete acids into urine, causing the blood to become too acidic. If this becomes a chronic condition, then rapid complications can occur such as kidney stones, growth retardation, chronic kidney disease, bone disease and even possibly total kidney failure.

    Nephrotic Syndrome

    • Nephrotic syndrome is also another complication of long-time use of lithium. The syndrome has features such as low levels of protein in blood, high levels of protein passed in urine called proteinuria and swelling, especially in the eyes, feet and hands. Cholesterol may also become higher.

    Conclusion

    • Mental health patients should be aware of bodily effects of their medicine and not only cognitive effects. Renal failure, in general, seems to have a high occurrence in lithium treatment. However, lithium's positive track record with bipolar disorder cannot be overlooked. Be cautious when using lithium and contact your doctor immediately if you experience any complications.

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