Lithium induced renal disease
Citation, DOI and article data
Lithium induced renal disease is characterized by a progressive decline in renal function, evidenced by increasing serum creatinine and decreased creatinine clearance. The lithium salt causes direct injury to the renal tubules. The duration of lithium therapy increases the risk of progression to end-stage renal disease (ESRD), however, discontinuation of medication may not necessarily halt the progression to ESRD.
Renal biopsy demonstrates tubular atrophy, glomerulosclerosis, chronic interstitial nephritis, and distal tubular dilatation with microcyst formation 1.
Unique imaging appearance of numerous uniform microcysts and punctate echogenic foci which may be cortical or medullary in origin 2. The kidneys are normal in size.
- may show microcalcifications within the microcysts in the renal medulla and cortex
- T2: abundance of microcysts as small hyperintense 1-2 mm round lesions distributed randomly in the renal medulla and cortex 3
- 1. Markowitz GS, Radhakrishnan J, Kambham N, Valeri AM, Hines WH, D'Agati VD. Lithium nephrotoxicity: a progressive combined glomerular and tubulointerstitial nephropathy. (2000) Journal of the American Society of Nephrology : JASN. 11 (8): 1439-48. Pubmed
- 2. Di Salvo DN, Park J, Laing FC. Lithium nephropathy: unique sonographic findings. (2012) Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 31 (4): 637-44. Pubmed
- 3. Farres MT, Ronco P, Saadoun D, Remy P, Vincent F, Khalil A, Le Blanche AF. Chronic lithium nephropathy: MR imaging for diagnosis. (2003) Radiology. 229 (2): 570-4. doi:10.1148/radiol.2292020758 - Pubmed