Effects of lithium on the kidney

Lithium has been used in medicine for more than a century and was used by Garrod [1] for the treatment of gout and rheumatism. Toxic effects (diarrhea, nausea, anorexia, vomiting, muscle weakness, dizziness, tremor, polyuria, oliguria, and stiffness in cats and dogs) were reported early in this century by Good [2] and Cleaveland [3], and some of the physiologic effects of lithium were described [4]. The use of lithium was generally discarded until 1949 when Cade [5] reported its use and effectiveness in the treatment of mania. Confirmation of these reports [6, 7] has led to the widespread use of lithium in psychiatric practice, and it is regarded as an indispensable and major drug in the psychiatrists' therapeutic armentarium [8].Lithium is an element in the periodic table in the same group as sodium and potassium, and it is not surprising that a large number of side-effects have been reported [9, 10]. Some of these effects may be due to replacement of sodium or potassium in the plasma or cell, but many appear to be a direct effect of the ion [11, 12].In this review, we will discuss the general effects on the body of lithium, including the pathologic lesions that exist in the kidney and a detailed review of the effects of lithium on electrolyte and water excretion