{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T20:41:54Z","timestamp":1759178514071,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,7,8]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>Lithium is an effective mood stabiliser used to treat bipolar affective disorder (BPAD); however, it can also adversely affect the kidneys, causing acute toxic effects, nephrogenic diabetes insipidus, chronic renal dysfunction and end-stage kidney disease (ESKD) in a minority of patients. We describe the case of a man with a 34-year history of BPAD type-1 and a 2-year history of ESKD secondary to lithium-induced nephropathy who experienced a manic relapse. He previously responded well to lithium but, following a deterioration in kidney function, was switched to olanzapine and sodium valproate. This precipitated a period of instability, which culminated in a treatment-resistant manic episode requiring hospital admission. After a multidisciplinary team discussion, lithium therapy was restarted and provided remission. This was achieved safely through a reduced dosing schedule of three times a week post dialysis, slow dose titration and blood level monitoring prior to each dialysis session.<\/jats:p>","DOI":"10.1136\/bcr-2021-242841","type":"journal-article","created":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T10:36:15Z","timestamp":1627641375000},"page":"e242841","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Lithium use in a patient on haemodialysis with bipolar affective disorder and lithium-induced nephropathy"],"prefix":"10.1136","volume":"14","author":[{"given":"Sam","family":"Topp","sequence":"first","affiliation":[{"name":"Hounslow Crisis Assessment & Treatment Team, West London Mental Health NHS Trust, Isleworth, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4357-3787","authenticated-orcid":false,"given":"Emma","family":"Salisbury","sequence":"additional","affiliation":[{"name":"Renal and Transplant, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,7,30]]},"reference":[{"key":"2025082708252083000_14.7.e242841.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f3646"},{"key":"2025082708252083000_14.7.e242841.2","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2015.4"},{"key":"2025082708252083000_14.7.e242841.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61516-X"},{"key":"2025082708252083000_14.7.e242841.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61842-0"},{"key":"2025082708252083000_14.7.e242841.5","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1053\/j.ajkd.2016.11.005","article-title":"AJKD atlas of renal pathology: lithium nephrotoxicity","volume":"69","author":"Fogo","year":"2017","journal-title":"Am J Kidney Dis"},{"key":"2025082708252083000_14.7.e242841.6","doi-asserted-by":"crossref","DOI":"10.1186\/1471-244X-14-93","article-title":"Development of acute pancreatitis caused by sodium valproate in a patient with bipolar disorder on hemodialysis for chronic renal failure: a case report","volume":"14","author":"Okayasu","year":"2014","journal-title":"BMC Psychiatry"},{"key":"2025082708252083000_14.7.e242841.7","doi-asserted-by":"crossref","first-page":"289","DOI":"10.5152\/tjg.2015.0216","article-title":"Olanzapine-Induced acute pancreatitis","volume":"26","author":"Baysal","year":"2015","journal-title":"Turk J Gastroenterol"},{"key":"2025082708252083000_14.7.e242841.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0231883","article-title":"Drug induced pancreatitis: a systematic review of case reports to determine potential drug associations","volume":"15","author":"Wolfe","year":"2020","journal-title":"PLoS One"},{"key":"2025082708252083000_14.7.e242841.9","doi-asserted-by":"crossref","DOI":"10.1192\/bjo.2019.83","article-title":"Clinical course and need for hospital admission after lithium discontinuation in patients with bipolar disorder type I or II: mirror-image study based on the LiSIE retrospective cohort","volume":"5","author":"\u00d6hlund","year":"2019","journal-title":"BJPsych Open"},{"key":"2025082708252083000_14.7.e242841.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m4603"},{"key":"2025082708252083000_14.7.e242841.11","doi-asserted-by":"crossref","DOI":"10.1136\/ebm.10.1.28","article-title":"Loop diuretics and angiotensin converting enzyme inhibitors increased risk of hospital admission for lithium toxicity","volume":"10","author":"Laville","year":"2005","journal-title":"Evid Based Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-242841","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:25:28Z","timestamp":1756308328000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-242841"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":11,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,30]]},"published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1136\/bcr-2021-242841"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-242841","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}