Lithium and Chronic Kidney Disease

Lithium is a drug used to treat some mental disorders. But long-term use of lithium can harm the kidneys. If you are taking lithium, regular lab tests can tell you how well your kidneys are working. Lowering the dosage of lithium can help reduce kidney damage.¹

Lithium as a treatment

Lithium is used as a mood stabilizer. It is usually given to people with bipolar disorder. It may also be used to treat schizophrenia and major depression.^2,3

People with bipolar disorder may experience manic or depressive episodes. Lithium can:^2,3

• Reduce how often these episodes occur
• Help create a balance so that the manic and depressive episodes are milder
• Reduce suicidal thoughts

How lithium affects the kidneys

Lithium can increase your chances of developing kidney disease. The damage to the kidneys may happen suddenly (acute) or over time (chronic). People who take lithium are more likely to develop chronic kidney disease (CKD).^1-3

Lithium can also cause nephrogenic diabetes insipidus. This is a disorder that can cause you to pee (urinate) more often. Your body loses too much water. This can lead to dehydration and extreme thirst.¹

The following factors can put you at a higher risk for kidney disease:^2,3

• Taking a high dose of lithium
• Regularly taking lithium over a long period of time
• Old age
• Having another condition that affects kidney function
• How well your kidneys function before you start taking lithium

Lithium and kidney function decline

Studies have been done to find out the risk for kidney disease for people taking lithium. Most studies estimate that 10 to 35 percent of people taking lithium eventually get CKD. People are most likely to develop CKD 5 to 15 years after starting lithium treatment.²

A 2021 study looked at data from roughly 1,000 people taking lithium who also had regular lab tests to check their kidney function. The results showed that 12 percent eventually developed CKD. In another study that included about 250 people taking lithium, 29 percent of them developed CKD. The large variation between results from different studies is likely due to the small number of people included in the studies.^2,3

Symptoms of kidney damage

If you are taking lithium, be aware of the symptoms that are related to kidney damage. These can include:¹

• Changes in how often or how much you pee
• Feeling weak or tired
• Dehydration
• Muscle pain

Preventing kidney disease

Finding the right dose of lithium can help prevent or reduce kidney damage. If you are taking lithium, your doctor will work with you to find the right dosage. A lithium serum test checks for the amount of lithium in the blood. Depending on the lithium levels in the blood, your doctor may increase or decrease the dosage to maximize the benefits while also reducing the side effects.^1-3

While you are taking lithium, you will have lab tests to track your kidney function. If your kidney function reduces too much, the lithium may need to be stopped. In this case, your doctor may suggest different treatment options.^1-3

Some types of kidney damage due to lithium can go away after you stop taking lithium. In some cases, the symptoms of nephrogenic diabetes insipidus caused by lithium will go away after you stop taking lithium. But some types of kidney damage may be permanent. This is why your kidney function should be closely monitored if you are taking lithium.^1,3