Kidney function in lithium-treated patients. A literature survey.

UNLABELLED

Twenty-three studies of the effect of lithium treatment on tubular and glomerular function are reviewed. They include about 1,450 patients from a total population of more than 2,000. One hundred and thirty-two patients were kidney biopsied. In addition, two specific questions are reviewed: 1) Does combined treatment lithium/neuroleptics affect the kidneys adversely? 2) Do different lithium preparations or treatment schedules affect the kidneys differently?

CONCLUSIONS

In a small proportion of patients long-term lithium treatment causes morphological changes of a tubulointerstitial type and partly irreversible reduction of tubular function. Glomerular function is reduced secondary to tubular atrophy. Combined treatment with neuroleptics does not increase the risk of kidney damage. Types of lithium preparation do not affect kidneys differently. Multiple-dose schedules may be associated with a higher urinary output than one-dose schedule. Reduced renal function may in the future become a problem in an increasing number of patients.