Hypercalcemia and diabetes insipidus in a patient previously treated with lithium

Nat Clin Pract Nephrol. 2007 Jul;3(7):397-404. doi: 10.1038/ncpneph0525.


Background: A 65-year-old woman presented with decreased oral intake, a reduced level of consciousness, hypercalcemia and hypernatremia. She had previously received lithium for 20 years for a schizoaffective disorder, but this treatment had been discontinued 3 years before presentation.

Investigations: Physical examination, laboratory studies including measurement of serum calcium and parathyroid hormone levels, measurement of urine and serum osmolalities before and after desmopressin administration, blood and urine cultures, and a CT scan of the abdomen.

Diagnosis: Urosepsis, dehydration, kidney stone disease, hyperparathyroidism, and nephrogenic diabetes insipidus.

Management: Hydration, antibiotics, intravenous pamidronate for rapid control of hypercalcemia, parathyroidectomy, surgical removal of the large kidney stones, a low-protein and low-sodium diet, and initiation of treatment with a thiazide diuretic.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Diabetes Insipidus, Nephrogenic / chemically induced*
  • Diabetes Insipidus, Nephrogenic / complications
  • Diabetes Insipidus, Nephrogenic / diagnosis
  • Female
  • Follow-Up Studies
  • Humans
  • Hypercalcemia / chemically induced*
  • Hypercalcemia / complications
  • Hypercalcemia / diagnosis
  • Hyperparathyroidism / chemically induced*
  • Hyperparathyroidism / complications
  • Hyperparathyroidism / surgery
  • Kidney Calculi / chemically induced*
  • Kidney Calculi / complications
  • Kidney Calculi / surgery
  • Lithium Carbonate / administration & dosage
  • Lithium Carbonate / adverse effects*
  • Long-Term Care
  • Parathyroidectomy / methods
  • Risk Assessment
  • Schizophrenia / diagnosis
  • Schizophrenia / drug therapy
  • Treatment Outcome


  • Lithium Carbonate