MyPsych App
- Lithium is nephrotoxic and contra-indicated in severe renal impairment.
- Use with extreme care, close monitoring, reduced dosing and following consultation with renal medicine and biochemistry.
- Toxicity is more likely.
- A full discussion of the additional risks must be undertaken with the patient and consent obtained and documented.
Referral to renal medicine should be made if:
- eGFR falls rapidly to <45ml/min.
- Significant proteinuria (identified by albumin creatinine ratio).
- A steady or persistent fall in eGFR.
- eGFR <30ml/min (Stages 4 or 5 of chronic kidney disease).
Lithium levels and renal function should be monitored more frequently and at least monthly for patients with altered renal function.