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Lithium and nephrotoxicity: unravelling the complex pathophysiological threads of the lightest metal

journal contribution
posted on 2018-10-01, 00:00 authored by J Davis, M Desmond, Michael BerkMichael Berk
While lithium remains the most efficacious treatment for bipolar disorder, it can cause significant nephrotoxicity. The molecular mechanisms behind both this process and the development of nephrogenic diabetes insipidus still remain to be fully elucidated but appear to involve alterations in glycogen synthase kinase 3 signalling, G2 cell cycle progression arrest, alterations in inositol and prostaglandin signalling pathways, and dysregulated trafficking and transcription of aquaporin 2 water channels. The end result of this is a tubulointerstitial nephropathy with microcyst formation and relative glomerular sparing, both visible on pathology specimens and increasingly noted on non-invasive imaging. This paper will elucidate on the current evidence pertaining to the pathophysiology of lithium induced nephrotoxicity.

History

Journal

Nephrology

Volume

23

Issue

10

Pagination

897 - 903

Publisher

John Wiley & Sons

Location

Chichester, Eng.

eISSN

1440-1797

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2018, Asian Pacific Society of Nephrology