Renal sonography in bipolar patients on long‐term lithium treatment

Abstract

The presence of macrocysts in the kidneys of lithium-treated bipolar patients is associated with impaired renal function. The US changes characteristic for lithium nephropathy are rare, and in our study, were only found in patients treated with lithium for 20 years or more. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:354-359, 2016.

Lithium nephropathy: Unique sonographic appearance and application of new on cart tools

“…The presence of microcysts with punctate echogenic foci, found in both the cortex and medulla, is the most likely ultrasound finding to accompany the development of lithium‐induced nephropathy. This finding correlates histologically; however, studies report difficulty detecting these cysts because of their small size . In our case, visualisation of these findings was due to the improved imaging resolution and the use of new on cart technologies.…”

“…Lithium is a widely utilised therapeutic agent used to prevent manic and depressive recurrences in patients with schizoaffective disorders. While this treatment is very effective, concerns have been raised about its potential for renal toxicity …”

“…A retrospective study revealed that 85% of patients in 14 studies did not demonstrate signs of renal failure and only 0.37% had altered histopathological analysis . The ultrasound changes seen as a result of lithium‐induced nephropathy are also uncommon, having only been reported in a few patients with prolonged lithium therapy (>20 years) …”

“…Pathology was ordered, and the patient was found to have a Creactive protein (CRP) of 580 mg/L, a creatinine of 208 mg/dL and an While this treatment is very effective, concerns have been raised about its potential for renal toxicity. 1,2 Previous studies have reported complications as a result of lithium use, which include nephrogenic diabetes insipidus, renal tubular acidosis, tubulointerstitial nephritis, and nephrotic syndrome, with chronic tubulo-interstitial nephropathy (CTIN), which is the most common.…”

“…3 The ultrasound changes seen as a result of lithium-induced nephropathy are also uncommon, having only been reported in a few patients with prolonged lithium therapy (>20 years). 1 A study by Di Salvo et al 4 described that lithium-induced tubulointerstitial nephritis is characterised histologically by distal tubular microcysts and interstitial fibrosis. The presence of microcysts with punctate echogenic foci, found in both the cortex and medulla, is the most likely ultrasound finding to accompany the development of lithium-induced nephropathy.…”