Lithium is the first line therapy of bipolar mood disorder. Lithium-induced nephrogenic diabetes insipidus (Li-NDI) and lithium nephropathy (Li-NP, i.e., renal insufficiency) are prevalent side effects of lithium therapy, with significant morbidity. The objective of this systematic review is to provide an overview of preventive and management strategies for Li-NDI and Li-NP. For this, the PRISMA guideline for systematic reviews was used. Papers on the prevention and/or treatment of Li-NDI or Li-NP, and (influenceable) risk factors for development of Li-NDI or Li-NP were included. We found that the amount of evidence on prevention and treatment of Li-NDI and Li-NP is scarce. To prevent Li-NDI and Li-NP we advise to use a once-daily dosing schedule, target the lowest serum lithium level that is effective and prevent lithium intoxication. We emphasize the importance of monitoring for Li-NDI and Li-NP, as early diagnosis and treatment can prevent further progression and permanent damage. Collaboration between psychiatrist, nephrologist and patients themselves is essential. In patients with Li-NDI and/or Li-NP cessation of lithium therapy and/or switch to another mood stabilizer should be considered. In patients with Li-NDI, off label therapy with amiloride can be useful.

中文翻译：

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锂疗法肾脏副作用预防和管理的系统评价和实用指南

锂是双相情绪障碍的一线疗法。锂剂引起的肾性尿崩症（Li-NDI）和锂剂肾病（Li-NP，即肾功能不全）是锂剂治疗的普遍副作用，发病率很高。本系统综述的目的是概述 Li-NDI 和 Li-NP 的预防和管理策略。为此，使用了 PRISMA 系统评价指南。包括关于 Li-NDI 或 Li-NP 的预防和/或治疗以及 Li-NDI 或 Li-NP 发展的（可影响的）风险因素的论文。我们发现关于预防和治疗 Li-NDI 和 Li-NP 的证据很少。为了防止 Li-NDI 和 Li-NP，我们建议使用每日一次的给药方案，以有效的最低血清锂水平为目标并防止锂中毒。我们强调监测 Li-NDI 和 Li-NP 的重要性，因为早期诊断和治疗可以防止进一步进展和永久性损伤。精神科医生、肾脏科医生和患者本身之间的合作是必不可少的。对于 Li-NDI 和/或 Li-NP 患者，应考虑停止锂疗法和/或改用另一种情绪稳定剂。对于 Li-NDI 患者，使用阿米洛利的标签外治疗可能有用。