Late side effects of lithium treatment.

M Schou
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Abstract

Many patients have now been given lithium for 10-15 years, and the overall picture as regards late side effects is not alarming. Changes of renal morphology and function currently attract interest. Histologically demonstrate interstitial nephropathy may be observed in 10-15% of patients, but glomerular filtration rate is little affected or unaffected, and the risk of progressive renal failure with terminal azotemia is remote even in patients given lithium for many years. Renal water reabsorption is often impaired, and the patients may develop polyuria or lowered concentrating ability. These changes are not in themselves dangerous, but since dehydration may lead to lithium poisoning, the patients should drink extra water during situations with risk of a negative water balance.

锂治疗的后期副作用。
许多患者现在已经服用了10-15年的锂,关于晚期副作用的总体情况并不令人担忧。肾脏形态和功能的变化目前引起了人们的关注。组织学上显示,10-15%的患者可观察到间质性肾病,但肾小球滤过率几乎未受影响或不受影响,即使在服用锂多年的患者中,进展性肾衰竭伴终末期氮质血症的风险也很低。肾水重吸收常受损,患者可出现多尿或注意力不集中。这些变化本身并不危险,但由于脱水可能导致锂中毒,在有负水平衡风险的情况下,患者应多喝水。
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