Lithium nephrotoxicity: a review

Lithium, a group I alkali metal, is widely used for treatment of manic-depressive psychosis. A number of toxic side effects have been reported, among which the most common ones are nephrogenic diabetes insipidus, distal tubular acidosis, and impairment of renal concentrating ability. The proposed mechanisms in the literature of these renal complications of lithium salt therapy are reviewed. None of the proposed mechanisms can be definitively established. Recently reported observations contradict the causative role of lithium in the pathogenesis of renal complications. More careful selection of control subjects is required for further investigation of the nephrotoxic effects of lithium.