[Renal side effects of long-term lithium therapy]

Dtsch Med Wochenschr. 2012 Jan;137(4):143-8. doi: 10.1055/s-0031-1298814. Epub 2012 Jan 18.
[Article in German]


Lithium is widely used in the treatment of bipolar disorders. Long-term administration of lithium often leads to side effects concerning the subjects: nephrology, endocrinology and surgery. This review emphasizes nephrotoxicity.Lithium treatment may disturb responsiveness to antidiuretic hormone (ADH), causing a nephrogenic diabetes insipidus. Furthermore long-term lithium therapy may trigger hyperparathyreoidism with hypercalcemia and chronic interstitial nephritis with development of microcysts. Long-term patients have an increased risk to develop impaired renal function. Lithium-induced endstage renal disease is rare. Termination of lithium treatment may decrease the risk of progression.To ensure security of lithium treatment regular controls of urine osmolarity, lithium-, creatinine- , thyroid stimulating hormone- and calcium-levels are essential. Patients with decreased renal function should be referred to a specialist early.

Publication types

  • Case Reports
  • English Abstract
  • Review

MeSH terms

  • Antidepressive Agents / adverse effects*
  • Antidepressive Agents / therapeutic use
  • Antimanic Agents / adverse effects*
  • Antimanic Agents / therapeutic use
  • Atrophy / chemically induced
  • Bipolar Disorder / drug therapy
  • Diabetes Insipidus, Nephrogenic / chemically induced
  • Female
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Hypercalcemia / chemically induced
  • Hypercalcemia / complications
  • Hyperparathyroidism / chemically induced
  • Hyperparathyroidism / complications
  • Kidney / drug effects*
  • Kidney Diseases / chemically induced*
  • Kidney Diseases / pathology
  • Kidney Tubules / pathology
  • Lithium Compounds / adverse effects*
  • Lithium Compounds / therapeutic use
  • Male
  • Middle Aged
  • Nephritis, Interstitial / chemically induced
  • Nephritis, Interstitial / complications


  • Antidepressive Agents
  • Antimanic Agents
  • Lithium Compounds