LITHIUM-INDUCED RENAL-INSUFFICIENCY

Recent reviews of the effects of lithium on renal function have genera lly concluded that no clinically significant effect on glomerular func tion is apparent even after many years. Yet, a handful of studies over the last 3 years indicate that a small percentage of lithium-treated patients may develop rising levels of creatinine in serum after a deca de or more of treatment. In the current sample of 82 bipolar patients treated in an affective disorders clinic, 3 (3.7%) were found to have developed creatinine levels in serum greater than 2.0 mg/100 ml from b aseline levels that were within normal limits. One of these patients h as progressed to chronic renal failure and hemodialysis, making him th e second probable reported case of lithium-induced chronic renal failu re. No common risk factor for renal disease among these patients was a pparent. As increasing numbers of patients are treated with lithium fo r a decade or more, previous conclusions as to the benign effects of l ong-term lithium treatment on renal function may need to be revised. R egular monitoring of creatinine levels in serum and medical consultati on if the level rises and remains above 1.6 mg/100 ml are recommended.