Lippmann S
Postgrad Med. 1982 Mar;71(3):99-104, 107-8. doi: 10.1080/00325481.1982.11716015.
Although lithium was known to cause changes in renal physiology, it was considered safe until reports in late 1977 suggested that it may induce chronic irreversible nephropathy. Later reports documented similar lesions in non-lithium-treated patients with affective disturbances. Thus, the data are inconclusive. Concern for the kidney during lithium therapy is now greater than it was originally, but confidence in lithium's safety is higher than it has been for the past four years. Physician appreciation of the foregoing factors, careful patient selection, and informed consent are important in lithium therapy. An understanding of lithium use in patients in a low-sodium state or on diuretic therapy and avoidance and treatment of lithium intoxication are advocated. Good prelithium workups and closer monitoring of patients on long-term lithium therapy are recommended.
尽管已知锂会引起肾脏生理变化，但在1977年末有报告表明其可能诱发慢性不可逆肾病之前，一直被认为是安全的。后来的报告记录了在未接受锂治疗的情感障碍患者中也有类似病变。因此，数据尚无定论。目前，在锂治疗期间对肾脏的关注比最初时更多，但对锂安全性的信心比过去四年更高。医生了解上述因素、谨慎选择患者并取得知情同意在锂治疗中很重要。提倡了解低钠状态或接受利尿剂治疗的患者使用锂的情况，以及避免和治疗锂中毒。建议在使用锂之前进行完善的检查，并对长期接受锂治疗的患者进行更密切的监测。
