Comprehensive review on lithium nephrotoxicity: Unravelling pathophysiological mechanisms | ||
| Archives of Pharmaceutical Sciences Ain Shams University | ||
| Articles in Press, Accepted Manuscript, Available Online from 18 March 2025 | ||
| Document Type: Review Article | ||
| DOI: 10.21608/aps.2024.310817.1188 | ||
| Authors | ||
| nesreen osama shehab eldin* 1; Eman Mantawy2; Mariane G Tadros3 | ||
| 1pharmacology and toxicology, faculty of pharamcy , ain shams university | ||
| 2Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University | ||
| 3Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt | ||
| Abstract | ||
| Bipolar disorder is commonly treated with lithium. Its toxicity includes hypercalcemia, urine concentration deficit, natriuresis, renal tubular acidosis, and tubulointerstitial nephritis, which aggravates chronic kidney disease. With 20–40% of people experiencing it, diabetes insipidus is the most common adverse effect. a few weeks after therapy starts. The length of lithium usage is correlated with this kind of chronic nephropathy. Lithium accumulates in the collecting renal tubular cells, where it can contribute to tubulointerstitial disease, which can result in localized segmental glomerulosclerosis and the creation of microcystins. This accumulation of lithium is what causes lithium toxicity. The nephrologist and psychiatrist should work together to closely examine patients in order to discover renal failure early. The nephrotoxic effects of lithium substantially downgrade its clinical value in management of bipolar disorder. Carvedilol is a beta and alpha-1 blocker with diverse pharmacological activities. In this study, carvedilol mitigated lithium-triggered nephropathy through suppressing oxidative stress, inflammation, and fibrosis. These renoprotective effects were achieved by downregulating nuclear factor kappa b (NF-κB), transforming growth factor beta (TGF-β)/ connective tissue growth factor (CTGF) and c-Jun N-terminal kinase (JNK) signaling pathway | ||
| Keywords | ||
| Lithium; Bipolar disorder; nephropathy; Renal tubular acidosis; nephrogenic Diabetes insipidus; chronic kidney disease | ||
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