Lithium-induced_Tubular_Dysfunction

Lithium-induced_Tubular_Dysfunction - Lithium-induced...

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Lithium-induced Tubular Dysfunction Jun Ki Park 11/30/10
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Use of Lithium Mid 19 th century: treatment of gout Late 19 th century: used for psychiatric disorders Early 20 th century: sodium substitute to improve taste 1949: successful use of lithium for manic depressive disorders, first reported by Australian psychiatrist John Gade.
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Approximately 0.1% of the US population is undergoing lithium treatment for psychiatric problems. Known to cause urinary concentrating defects in as many as 40% of pts during and after lithium treatment. most common cause of nephrogenic diabetes insipidus. Up to 12% develop frank DI, and some continue to have this problem for years after discontinuing lithium.
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High ionization potential and water solubility, greater distribution through body water than Na or K Li is freely filtered through the glomeruli and up to 80% of the filtered load is reabsorbed, mostly in the proximal tubule Small fraction reabsorbed in distal parts of the nephron through ENaC
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Water Diuresis In rat kidney medulla, lithium for 25 days induced a severe water diuresis with marked (70%) down regulation for AQP2 water channel expression. Marples et al. 1995 Only partly reversed by stopping lithium, by thirsting or by DDAVP administration. Subsequent studies showed that the severity of lithium toxicity was time dependent, leading to morphological changes in the collecting duct after 2weeks of treatment.
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Lithium-induced_Tubular_Dysfunction - Lithium-induced...

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