Answer − D − Nephrogenic diabetes insipidus is a common adverse effect of lithium carbonate at therapeutic dosage. This syndrome occurs with polyuria and polydipsia and such patients should have their lithium discontinued as to avoid dehydration and permanent damage to the kidneys.
Nephrogenic diabetes insipidus (NDI) can be caused by long-term use of lithium carbonate, which is a medication commonly used to treat bipolar disorder. Lithium can interfere with the kidneys' ability to respond to vasopressin, which can result in the symptoms of NDI.
The exact mechanism by which lithium causes NDI is not fully understood, but it is believed to involve changes in the expression and activity of certain proteins in the kidneys, including aquaporin-2, which is a channel that allows water to be reabsorbed back into the body. Lithium may also affect the signaling pathways involved in the kidneys' response to vasopressin.
The risk of developing NDI from lithium use increases with the duration and dosage of treatment. People taking lithium may experience symptoms such as excessive thirst, frequent urination, dehydration, and electrolyte imbalances. If left untreated, NDI can lead to serious complications, such as kidney damage, seizures, and coma.
Regular monitoring of kidney function and electrolyte levels is essential for people taking lithium to detect any signs of NDI early and prevent complications. In some cases, reducing the dosage of lithium or switching to a different medication may be necessary to manage NDI.
