Hansen H E, Hestbech J, Sørensen J L, Nørgaard K, Heilskov J, Amdisen A
Q J Med. 1979 Oct;48(192):577-91.
One-hundred and ten patients treated with lithium for more than six months were studied in order to determine the prevalence of lithium induced nephropathy. Eighteen of 69 patients (26 per cent) who had been treated for more than two years 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 per cent 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 lithium treatment and the degree of tubular damage correlated with the degree of impairment of renal concentrating ability. Lithium induced, chronic nephropathy is a rather common complication of long-term lithium treatment and reduces the patients capacity to regulate water and electrolyte metabolism. As water and electrolyte loss appears to precede the slowly progressing lithium intoxication, the main hazard of lithium induced nephropathy is lithium intoxication.
为了确定锂诱导的肾病的患病率，对110名接受锂治疗超过6个月的患者进行了研究。在69名接受治疗超过两年的患者中，有18名（26%）出现了慢性间质性肾病，其特征是肾脏浓缩能力显著下降，而肾小球滤过率却不成比例地保留。组织学上，髓质和皮质中纤维化组织增多，同时伴有肾小管萎缩。在接受肾活检的患者中，40%的患者皮质出现囊性结构。肾脏浓缩能力的损害可能与锂治疗的持续时间有关，肾小管损伤的程度与肾脏浓缩能力的损害程度相关。锂诱导的慢性肾病是长期锂治疗相当常见的并发症，会降低患者调节水和电解质代谢的能力。由于水和电解质流失似乎先于缓慢进展的锂中毒，锂诱导的肾病的主要危害是锂中毒。
