Lithium-associated kidney effects

  • Daniel Batlle
  • Edgar V. Lerma
  • Parveen Naaz
  • Santosh Hakkapakki

Since its introduction several decades ago for the occasional treatment of “ psychotic excitement”, lithium is still a mainstay in the treatment and prophylaxis of manic-depressive disorders [1]. The biologic basis for the clinical efficacy of lithium is not completely known. Interestingly, the agent relieves both mania and depression, states which appear to be opposites. Its therapeutic range, however, is narrow, and even at the lowest effective dosage, some unwanted side effects may occur [2]. Serum levels above 1.5 mEq/L often result in acute intoxication, which may be severe. The therapeutic range varies, depending on methodology, but it is advisable to target a level of about 0.5 mEq/L, with an upper range at 1.0 mEq/L. Values above this level signify a warning range of impending toxicity.

Because lithium is cleared from the body by the kidneys, its blood level at a given dosage depends critically on renal excretion, which is subject to various physiological and pathological influences. An insight into renal “lithium handling” is a prerequisite for effective prevention of complications and treatment of lithium intoxication when it occurs. Another reason why lithium is of interest to nephrologists is that its clearance has been used as a tool to investigate segmental tubular function [6-9].


Cyclic Adenosine Monophosphate Lithium Treatment AQP2 Expression Nephrogenic Diabetes Insipidus Lithium Therapy 
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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Daniel Batlle
    • 1
  • Edgar V. Lerma
    • 1
  • Parveen Naaz
    • 1
  • Santosh Hakkapakki
    • 1
  1. 1.Division of Nephrology/HypertensionNorthwestern University, Feinberg School of MedicineChicagoUSA

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