A micropuncture study of the renal handling of lithium.

Although clearance studies in man and experimental animals indicate that filtered lithium is reabsorbed primarily in the proximal tubule, it is unclear whether lithium is also reabsorbed in distal portions of the nephron. Micropuncture studies were, therefore, performed to determine the nephron sites involved in lithium transport during free flow. A method was established to estimate the concentration of lithium in nanoliter samples, using the Helium Glow photometer, which permitted the accurate measurement of lithium in tubular fluid samples over a range from 0.5--30.0 mM. Approximately 56% of filtered lithium and tubular fluid was reabsorbed at the end of the proximal convolution, while at the early distal tubule 75% of filtered lithium and water was reabsorbed. There was no change in net transepithelial movement of lithium beyond the loop of Henle. These data suggest that lithium transport is localized to the proximal tubule, including the pars recta. Lithium reabsorption does not occur in distal tubule or collecting duct. Beyond the early distal tubule net movement of lithium and sodium is dissociated.