Korean J Nephrol.  2004 May;23(3):500-504.

A Case of Minimal Change Disease with Chronic Tubulointerstitial Nephritis by Lithium Nephrotoxicity

• Ha HJ
• Jung EY
• Baek JE
• Kim HJ
• Lee GW
• Yang JI
• Park DJ
• Chang SH

Abstract

Lithium is commonly employed in the treatment of bipolar disorders. The commonly reported nephrotoxic effects of lithium therapy are nephrogenic diabetes insipidus and chronic tubulointerstitial nephropathy with little or no proteinuria. Mild proteinuria is a common manifestation of most renal injuries including nephrotoxicity by lithium. But nephrotic syndrome related with lithium therapy is very rare and only one case of membranous glomerulonephritis has been reported in Korea by this time. We report a lithium toxicity case manifested by nephrotic syndrome, nephrogenic diabetes inspidus and chronic renal insufficiency in a 44-year-old man who had been taking lithium for 13 years for bipolar disorder. Kidney pathology showed minimal change disease and chronic tubulointerstitial nephritis which can be seen in chronic lithium toxicity. Polyuria and massive proteinuria disappeared with the withdrawal of lithium. Renal function was gradually improved but not to norma range. Careful and regular monitoring on the renal function in all patients on lithium treatment will be needed.

Keyword

Lithium; Minimal change disease; Nephrogenic diabetes insipidus; Renal insufficiency; Chronic tubulointerstitial nephritis

MeSH Terms

Adult
Bipolar Disorder
Diabetes Insipidus, Nephrogenic
Glomerulonephritis, Membranous
Humans
Kidney
Korea
Lithium*
Nephritis, Interstitial*
Nephrosis, Lipoid*
Nephrotic Syndrome
Pathology
Polyuria
Proteinuria
Renal Insufficiency
Renal Insufficiency, Chronic
Lithium