Review of Lithium-Induced Renal Dysfunction – Pathophysiology | Diagnosis | Management

Posted on:April 26, 2022
Last Updated: November 10, 2023
Time to read: 11–13 minutes

Lithium-induced nephropathy has been reported since the 1970s and covers many kidney function impairments. [Kallner and Peterson 1995]; [Markowitxz et al 2000]; [McKnight et al 2012]

There are broadly three types of renal issues associated with Lithium:


  • The most commonly reported renal adverse event is impaired urinary concentration in about 40% of patients.

Nephrogenic Diabetes Insipidus (NDI): 

  • Lithium therapy can also induce tubular dysfunction causing nephrogenic diabetes insipidus (NDI).
  • It presents with polyuria, nocturia and polydipsia.
  • It can occur as early as 8 weeks after treatment and is reversible during the first 6 years of exposure.

Chronic Kidney Disease:

  • Over a prolonged period of lithium usage (≥20 years), evidence suggests that lithium can lead to end-stage renal disease (ESRD), the final and permanent stage of chronic kidney disease (CKD).