Lithium intoxication with acute renal failure and death.

A 65-year-old female presented with only gastrointestinal symptoms eight to ten hours after an acute ingestion of an unknown amount of lithium carbonate. The serum lithium concentration was 8.5 mEq/L. Forty-eight hours postingestion she developed acute renal failure, deteriorating mental status, and cardiovascular collapse. Despite both hemodialysis and peritoneal dialysis the patient died approximately four and one-half days after ingestion. A direct nephrotoxic effect of lithium is proposed.