Lithium Toxicity - Associated Renal Disease: A Report of 9 Cases

Objectives To analyze the clinical characteristics and risk factors of lithium carbonate - in- duced renal disease complicated with nephritic syndrome and study its therapy and treatment efficacy. Methods The clinical data of 9 patients with lithium carbonate - induced renal disease were analyzed. Among them 5 cases were complicated with nephritic syndrome (NS) and treated with 0.5～1mg · (kg · d)-1 oral administered predni- seRe orally together with symptomatic treatment, and 3 of the 5 cases received renal biopsy for excluding primary glomerulonephropathies. Results The cases complicated with NS had received 10.2±3.2 years of lithium treatment which was significantly longer than 4.3±2.2 years in cases without NS, while there was no significant difference between the serum lithium concentrations in the two groups. Dehydration was significantly less in cases complicated with NS, comparted to those without NS. Renal biopsy in the cases with NS shown interstitial leucocyte infiltration and fibrosis, tubular degenaration and focal necrosis, and no obvious glomerulopathy under light microscopy. All cases were cured and nephrotic syndrome remitted. No side effect of prednisone treatment observed. Conclusions It is suggested that lithium carbonate - induced renal disease complicated with nephritic syndrome is neither less nor obviously related to serum lithium concentration, long term of lithium treatment might be one of its risk factors and orally administered prednison is effective to it, while diarrhea and dehydration is the risk factor of lithium - induced renal disease without NS. Key words: Kidney Disease;  Nephrotic Syndrome;  Lithium