Lithium-induced tardive nephropathy: MRI contribution to the detection of pre-symptomatic renal abnormalities

Method To test the hypothesis, we examined 3 consecutive patients treated with lithium for more than a decade and with no signs of renal disease. The patients were specifically selected for showing estimated GFR (eGFR) close to the normal threshold of 60 mL/min/1.73 m2. Results Two out of these 3 patients displayed 5-10 renal microcysts measuring from 1 to 2 mm in diameter in each kidney. The patients were a 53 y.o. female and a 48 y.o. male on lithium therapy for 17 and 22 years and with an eGFR of 67 and 63 mL/min/1.73 m2, respectively (Table I). Neither patient presented with factors considered to be related to the development of tardive nephropathy, e.g., past episodes of lithium intoxication or elevated serum lithium levels.