Nephropathy Associated With Prolong Lithium Administration

Lithium carbonate is often used for treatment of bipolar disorder, but caries various side effects affecting kidney function such as polyuria, impaired renal concentrating ability, impaired urinary acidification, and chronic tubule-interstitial nephropathy. Additionally, while the renal nephropathy due to prolong lithium therapy with minimal change disease has been well reported in the literature, focal segmental glomeruloseclerosis (FSGS) after discontinuation of lithium therapy has not been commonly described. We report a case from a 54 year-old obese male patient with past medical history of diabetes mellitus and bipolar affective disorder with treatment of lithium for 10 years presented with recent worsening of proteinuria and serum creatinine. Renal biopsy revealed tubule-interstitial disease, glomerulosclerosis and FSGS after discontinuation of lithium therapy. The report outlines the importance of early detection of nephropathy associated with long-term lithium administration is important to prevent progression to end-stage renal disease, and need for more research work in this area