Kaczmarczyk Ireneusz, Sułowicz Władysław
Katedra i Klinika Nefrologii UJ CM.
Przegl Lek. 2013;70(6):397-9.
Lithium salts are the first-line drug therapy in the treatment of uni- and bipolar disorder since the sixties of the twentieth century. In the mid-70s, the first information about their nephrotoxicity appeared. Lithium salts have a narrow therapeutic index. Side effects during treatment are polyuria, polydipsia and nephrogenic diabetes insipidus. Accidental intoxication can cause acute renal failure requiring renal replacement therapy while receiving long-term lithium salt can lead to the development of chronic kidney disease. The renal biopsy changes revealed a type of chronic tubulointerstitial nephropathy. The imaging studies revealed the presence of numerous symmetric microcysts. Care of the patient receiving lithium should include regular determination of serum creatinine, creatinine clearance and monitoring of urine volume. In case of deterioration of renal function reducing the dose should be considered.
自20世纪60年代以来,锂盐一直是治疗单相和双相情感障碍的一线药物疗法。在70年代中期,首次出现了关于其肾毒性的信息。锂盐的治疗指数较窄。治疗期间的副作用包括多尿、烦渴和肾性尿崩症。意外中毒可导致急性肾衰竭,需要进行肾脏替代治疗,而长期接受锂盐治疗可能会导致慢性肾脏病的发展。肾活检改变显示为一种慢性肾小管间质性肾病。影像学研究显示存在大量对称性微囊肿。对接受锂盐治疗的患者的护理应包括定期测定血清肌酐、肌酐清除率以及监测尿量。如果肾功能恶化,应考虑减少剂量。