Mannitol infusions and lithium excretion.

Abstract

thyroxine 0.1 uig/100 ml, total fats 1,820 mg/100 ml, cholesterol 523 mg/100 ml, urea 516 mg/100 ml, creatinine 6.6 mg/100 ml, and uric acid 17 mg/100 ml. The glomerular filtration rate measured by creatinine clearance was 7 ml/min. The bladder was drained by an indwelling catheter and the patient was given triiodothyronine. After 10 days she recovered bladder control, the urea was 80 mg/ 100 ml, and the creatinine clearance 25 ml/min. The electroencephalogram became normal. After four months the urea was 42 mg/ 100 ml and the creatinine clearance 82 ml/min, and the patient was well in herself. Though myxoedema has been shown clinically and experimentally to cause weakness of the bladder muscle' we have not found any reports in the literature of renal failure occurring, as in our case. Retention of urine must now be included among the various clinical forms in which myxoedema presents itself.-We are, etc.,

Acute Lithium Intoxication

“…Lithium excretion has been hastened by the use of urea, which acts as an osmotic diuretic 4 but Mannitol has not been previously used in man. Obek 5 however showed that it increased lithium excretion in dogs. Alkaline diuresis in the form of added sodium bicarbonate 4 and M/6 Lactate 6 also appears to speed renal lithium excretion.…”