Maggio Giugno 2019 - Nefrologo in corsia

Ultrasonography in chronic lithium nephropathy: a case report


Lithium has always been used as a first-choice therapy in bipolar disorders. However, its therapeutic index is restricted by placing patients at risk of potential nephrotoxic effects ranging from polyuria, to Insipid Nephrogenic Diabetes, to chronic kidney disease with a slow reduction of renal function over time. The Nephrologist has the role to diagnose chronic lithium nephropathy, monitoring its evolution and optimizing the management of risks associated with the treatment. In fact, the main objective, to be shared with the psychiatrist, is to encourage the maintenance of therapy even in the presence of nephropathy. Renal ultrasound, a safe, repeatable and low-cost technique, is essential to pursue this goal as it not only confirms the diagnosis of chronic lithium nephropathy hypothesized on the basis of the history and clinical picture, but is also helpful in monitoring its evolution. In this paper, we report a case of chronic lithium nephropathy in order to analyze the etiopathogenesis of renal damage, the clinical-laboratory and histological picture and, in particular, the fundamental role of ultrasound imaging.


KEYWORDS: lithium, Insipid Nephrogenic Diabetes, polyuria, nephropathy, renal ultrasound

Sorry, this entry is only available in Italian. For the sake of viewer convenience, the content is shown below in the alternative language. You may click the link to switch the active language.


Il litio, elemento-traccia essenziale per la vita umana, è utilizzato in farmacologia clinica da oltre 50 anni quale valido trattamento nei disturbi bipolari per la comprovata efficacia e il basso costo [1], nonostante i potenziali effetti nefrotossici nei pazienti in terapia cronica che vanno dalla poliuria, al Diabete Insipido Nefrogenico (DIN), sino alla malattia renale cronica (MRC) con riduzione progressiva del GFR [2, 3]. 

La visualizzazione dell’intero documento è riservata a Soci attivi, devi essere registrato e aver eseguito la Login con utente e password.