In early studies, Schou1 directed attention to the renal effects of lithium ions in the treatment of affective psychoses. For the clinical psychiatrist, the effects of lithium on renal function, and especially the potential for irreversible damage under some circumstances, is of great importance.
The fairly recent demonstration of lithium-induced histological changes in the kidney2 is the most pressing issue requiring proper evaluation. Although a proper survey is still required, nephrologists seem to agree that widespread lithium treatment does not lead to large numbers of people presenting with chronic renal failure. The histological changes found may well, however, increase the likelihood of acute intoxication states.
Hestbech et al3 reported that patients receiving longterm lithium treatment and who also experienced acute intoxication syndromes showed changes characterized by chronic focal atrophy with interstitial fibrosis and numerous sclerotic glomeruli; these nonspecific changes were quantitatively different from those of a control