Lithium and Chronic Kidney Disease

What is lithium?

Lithium is a common medicine used to help calm mood for treating people with mental disorders. Since such disorders need lifelong treatment, long-term use of lithium may be harmful to organs, such as the kidneys.

How does lithium cause kidney damage?

Lithium may cause problems with kidney health. Kidney damage due to lithium may include acute (sudden) or chronic (long-term) kidney disease and kidney cysts. The amount of kidney damage depends on how long you have been taking lithium. It is possible to reverse kidney damage caused by lithium early in treatment, but the damage may become permanent over time.

What is nephrogenic diabetes insipidus?

The most common problem from taking lithium is a form of diabetes due to kidney damage called nephrogenic diabetes insipidus. This type of diabetes is different than diabetes mellitus caused by high blood sugar.

In nephrogenic diabetes insipidus, the kidneys cannot respond to anti-diuretic hormone (ADH), a chemical messenger that controls fluid balance. This results in greater than normal urine out-put and excessive thirst. It can be hard to treat nephrogenic diabetes insipidus.

What are the signs and symptoms of kidney damage and nephrogenic diabetes insipidus due to lithium?

When the kidneys are not able to control fluid balance you may notice:

  • Greater than normal urine out-put (polyuria), along with greater than normal fluid intake (polydipsia) due to excessive thirst
    • Getting up at night to urinate (nocturia) can be a sign of polyuria
  • Signs of modest dehydration
    • Low blood pressure while standing (orthostatic hypertension)
    • Very fast heart beat (tachycardia)
    • Dry mouth
  • Signs of severe dehydration
    • High blood sodium level (hypernatremia)
    • Change in mental status

Too much fluid loss can cause electrolyte imbalance. Electrolytes are minerals in your body that have an electric charge. Examples of electrolytes are sodium and potassium. Symptoms of electrolyte imbalance include:

  • Feeling weak without knowing why
  • Feeling very tired or sluggish
  • Having muscle pains
  • Feeling irritable or bad-tempered

How can I avoid kidney damage due to lithium?

If you take lithium, ask your healthcare provider about the following ways to prevent kidney damage from lithium:

  1. Avoid levels of lithium that are toxic for the kidneys.
  2. Check blood levels of lithium to make sure you are taking the lowest amount that gives the best results.
  3. Check blood levels of creatinine every year. Get medical help if your creatinine level stays above 1.6 mg/dl.
  4. If possible, take lithium once a day.

If you would like more information, please contact us.

© 2014 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.