{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:06:45Z","timestamp":1792112805832,"version":"4.4.0"},"reference-count":60,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T00:00:00Z","timestamp":1617321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["analyticalsciencejournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Applied Toxicology"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Despite the progress made in treating bipolar and unipolar affective disorders, lithium carbonate is still a common drug in psychiatric practice. Lithium\u2010related renal side effects include nephrogenic diabetes insipidus, chronic tubulointerstitial nephropathy, and acute kidney injury (AKI). Nephrotic syndrome (NS) is an uncommon but severe complication of lithium treatment. We present a 49\u2010year\u2010old female treated with lithium carbonate due to a recurrent depressive disorder who developed NS during this therapy. NS spontaneously remitted after the drug withdrawal. Since her lithium serum levels were within the recommended values, we performed a retrospective analysis of lithium\u2010induced NS cases trying to determine causes predisposing to the NS development, underlying histopathology, and preservation or irreversible loss of kidney function. This analysis revealed that in lithium\u2010induced NS with AKI, lithium serum level was the key determinant of AKI development (the\n                    <jats:italic>\u03b2<\/jats:italic>\n                    coefficient\u2009=\u20090.8499 with a confidence interval ranging from 0.7452 to 0.9546 and\n                    <jats:italic>p<\/jats:italic>\n                    value\u2009&lt;\u20090.0001). In these cases, the underlying pathology was mainly minimal change disease (MCD), which was quickly reversible upon the drug withdrawal. The development of chronic kidney disease (CKD) seemed to be associated with lithium therapy duration. However, the multiple regression analysis for CKD as the dependent variable showed that the decisive factor was focal segmental glomerulosclerosis (FSGS) as the underlying pathology (the\n                    <jats:italic>\u03b2<\/jats:italic>\n                    coefficient\u2009=\u20090.7866 with a confidence interval ranging from 0.600 to 0.9704 and the\n                    <jats:italic>p<\/jats:italic>\n                    value\u2009&lt;\u20090.0001). Thus, we conclude that in lithium\u2010induced NS\/AKI, serum lithium levels contribute to these complications, while FSGS lesions are responsible for CKD's disease progression.\n                  <\/jats:p>","DOI":"10.1002\/jat.4167","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T12:31:13Z","timestamp":1617366673000},"page":"1896-1909","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Lithium toxicity and the kidney with special focus on nephrotic syndrome associated with the acute kidney injury: A case\u2010based systematic analysis"],"prefix":"10.1002","volume":"41","author":[{"given":"Emilia","family":"\u0141ukawska","sequence":"first","affiliation":[{"name":"Department of Nephrology, Transplantology and Internal Diseases Pozna\u0144 University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorota","family":"Frankiewicz","sequence":"additional","affiliation":[{"name":"Department of Nephrology Provincial Integrated Hospital  Konin Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Izak","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Transplantology and Internal Diseases Pozna\u0144 University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldona","family":"Wo\u017aniak","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology Pozna\u0144 University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Dworacki","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology Pozna\u0144 University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1618-3596","authenticated-orcid":false,"given":"Zofia I.","family":"Niemir","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Transplantology and Internal Diseases Pozna\u0144 University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,2]]},"reference":[{"key":"e_1_2_13_2_1","first-page":"228","article-title":"Renal function and biopsy in patients on lithium\u2010therapy","volume":"3","author":"Albrecht J.","year":"1980","journal-title":"Pharmakopsychiatrie\u2010Neuro\u2010Psychopharmakologie"},{"key":"e_1_2_13_3_1","first-page":"267","article-title":"Nephrotic syndrome associated with lithium therapy","volume":"15","author":"Alexander F.","year":"1981","journal-title":"Clinical Nephrology"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5002578"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/newbio233267a0"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2015080907"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.305.6864.1273"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.04.016"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13202"},{"key":"e_1_2_13_10_1","first-page":"735","article-title":"Nephrotic syndrome and renal failure secondary to lithium carbonate therapy","volume":"132","author":"Bear R. 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