Lithium nephropathy

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The lithium nephropathy is a kidney disorder that in the lithium bipolar disorder may occur. The most common side effect of this treatment is nephrogenic diabetes insipidus , which occurs in around 40% of those treated. Within a few weeks, the kidneys excreted more water and sodium , resulting in a mild water deficiency (dehydration) and over- acidification of the blood (acidosis) . Decades of lithium treatment can lead to a reduction in the glomerular filtration rate and chronic kidney damage . In patients treated with lithium, the prevalence of chronic kidney damage is about 1.2%; compared to the normal population, the risk of developing kidney failure requiring dialysis is about six times higher. Lithium penetrates into the principal cells in the collecting tube of the renal tubule via the epithelial sodium channel , where it inhibits signaling pathways in which the enzyme glycogen synthase kinase type 3 beta is involved. This leads to a disturbed regulation of the aquaporin 2 water channel . Lithium nephropathy is prevented and treated with the diuretic amiloride . Amiloride blocks the epithelial sodium channel, preventing lithium from entering the principal cell. So far, however, there are no long-term observations on the therapy of lithium nephropathy with amiloride.

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