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The DOI matches its Crossref record; 11 of the 12 references it cites were found in a registry or an index.

Lithium-Induced Nephrogenic Diabetes Insipidus

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Stone, K. A.·1999·The Journal of the American Board of Family Medicine
DOI 10.3122/15572625-12-1-43
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Abstract

BACKGROUND: Lithium can cause nephrogenic diabetes insipidus in up to 20 to 40 percent of patients currently taking the medication, and a subset of these patients will have a persistent concentrating defect long after lithium is discontinued. They are at risk for serious hypernatremia when fluid intake is restricted for any reason. METHODS: MEDLINE as used to search the key words "nephrogenic diabetes insipidus" and "lithium" from 1990 to the present. A case report describes a patient who had been off lithium for 8 years and who developed hypernatremia after she was transferred to a new long-term facility and the staff attempted to control the patient's polydipsia. The diagnosis and treatment of nephrogenic diabetes insipidus are also discussed. RESULTS: This case of persistent nephrogenic diabetes insipidus 8 years after discontinuing lithium is the longest ever reported. Certainly, a number of patients have varying degrees of persistent lithium-related nephrogenic diabetes insipidus. Although pathologic changes are associated with persistent nephrogenic diabetes insipidus, the exact mechanism of the persistent defect is unknown. The mechanism of acute lithium-induced nephrogenic diabetes insipidus while the patient is on lithium is related to changes in intracellular cyclic adenosine monophosphate. CONCLUSIONS: Patients currently taking lithium and patients with a remote history of lithium treatment need to be monitored for signs and symptoms of nephrogenic diabetes insipidus. Physicians need to be aware of the potential for nephrogenic diabetes insipidus in these patients and care for them appropriately.

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  • Lithium has a well-recognized potential for renal toxicity, including nephrogenic diabetes insipidus (NDI), chronic tubulointerstitial nephropathy, and acute tubular necrosis, with NDI reported in 20%-40% of patients.

    “Lithium has a well‐recognized potential for renal toxicity, including nephrogenic diabetes insipidus (NDI), chronic tubulointerstitial nephropathy, and acute tubular necrosis, with NDI reported in 20%‐40% of patients.814, 815, 816”

    From Canadian Network for Mood and Anxiety Treatments ( CANMAT ) and International Society for Bipolar Disorders ( ISBD ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [814]

    The Abstract says lithium can cause NDI in up to 20–40% of current users, but the Discussion and Conclusions distinguish the 20–40% with symptoms of a concentrating defect from the 12% with frank NDI. The Pathophysiology section associates persistent defects with chronic tubulointerstitial changes; the paper does not identify acute tubular necrosis as a lithium toxicity. Page numbers are not indicated for these passages in the indexed copy. (LLM, conf=0.89)

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Research works printed but not linked: 3

  1. Peet M, PrattJP. Lithium. Current status in psychi- atric disorders. Drugs 1993;46:7-17.
  2. Allen lUI, Jackson RL, Winchester MD, Deck L\: Allon M. Indomethacin in the treatment of lithiwn- induced nephrogenic diabetes insipidus. Arch Intern Med 1989;149:1123-6.
  3. Burke C, Fulda GJ, Castellano J. Lithium-ind~ced nephrogenic diabetes insipidus treated with intra- venous ketorolac. Crit Care Med 1995;23:1914-7. Nephrogenic Diabetes Insipidus and Lithium 47 on 21 July 2023 by guest. Protected by copyright. http://www.jabfm.org/ J Am Board Fam Pract: first published as 10.3122/15572625-12-1-43 on 1 January 1999. Downloaded from

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Metadata

Authors
Stone, K. A.
Affiliations
Rapid City Regional Hospital (US)
Corresponding author
Stone, K. A.
Venue
The Journal of the American Board of Family Medicine
Publisher
American Board of Family Medicine (ABFM)
Published
1999-01-01
Volume
12
Issue
1
Pages
43-47
ISSN
  • 1557-2625 (ISSN-L)
  • 1558-7118
DOI
10.3122/15572625-12-1-43
OpenAlex
W2137849552
Cited by
91
References
12
Citations by year
2026: 2 · 2025: 1 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 1 · 2019: 4 · 2018: 4 · 2017: 4 · 2016: 3 · 2015: 8 · 2014: 4 · 2013: 8 · 2012: 4
FWCI
2.55
Type
journal article
Language
en
Open access
Locations
  • The Journal of the American Board of Family Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Nephrology › Electrolyte and hormonal disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Ion Transport and Channel Regulation
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Keywords
nephrogenic diabetes insipidus, lithium, drug-induced nephrotoxicity, hypernatremia, polydipsia, cyclic AMP
MeSH terms
Chlorthalidone, Diagnosis, Differential, Diuretics, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Lithium, Magnetic Resonance Imaging, Middle Aged, Retrospective Studies, Serotonin Antagonists, Diabetes Insipidus, Nephrogenic, Risperidone

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