Gabutti L, Gugger M, Marti H P
Departement Innere Medizin, Inselspital Bern.
Ther Umsch. 1998 Sep;55(9):562-4.
Long-term therapy with lithium may be associated with a broad spectrum of functional and structural side-effects in the kidney. Among these features, nephrogenic diabetes insipidus is the most frequent and it can be expected to occur in 20-70% of the patients. Diabetes insipidus is the result of a lithium induced resistance of collecting ducts to antidiuretic hormone. Additional functional disturbances are represented by renal tubular acidosis and consequences of hypercalcemia. Structural alterations of the kidney have a rare occurrence. In the literature, there are accounts of chronic tubulo-interstitial nephritis, acute tubular necrosis and few cases of glomerulopathies. Our report of a patient with chronic interstital nephritis is supplemented by a brief discussion of the diverse picture of the nephrotoxicity of lithium.
长期使用锂进行治疗可能会在肾脏产生一系列广泛的功能和结构方面的副作用。在这些特征中，肾性尿崩症最为常见，预计20%至70%的患者会出现。尿崩症是锂诱导集合管对抗利尿激素产生抵抗的结果。其他功能紊乱表现为肾小管酸中毒和高钙血症的后果。肾脏的结构改变较为罕见。文献中有关于慢性肾小管间质性肾炎、急性肾小管坏死以及少数肾小球病病例的记载。我们报告了一例慢性间质性肾炎患者，并简要讨论了锂肾毒性的多样表现。
