Lithium and Renal Failure

Lithium has a narrow therapeutic index and can consequently result in considerable toxicity if levels are not monitored regularly. Among lithium’s potential side effects are two types of renal toxicity: decreased renal concentrating ability and chronic renal failure. Lithium-induced polyuria is frequent, estimated to affect up to 40 % of patients, and usually develops early. It may be irreversible, especially if the treatment has been prescribed for more than 15 years. Chronic renal failure is observed in patients treated for more than 10–20 years. Its prevalence is estimated at 12 % after 19 years of treatment. Some patients (0.5 %) may reach end-stage renal disease.