One of the major side effects of lithium is nephrogenic diabetes
insipidus. The established treatment for the disorder is thiazide
diuretics, which are associated with hypokalemia and reduced lithium
excretion, predisposing the patient to lithium toxicity. Amiloride is a new
diuretic that reduces lithium-induced polyuria in animals without affecting
lithium or potassium levels. The authors found that 10-20 mg/day of
amiloride given to eight patients who had become hypokalemic while being
treated with hydrochlorothiazide for lithium-induced nephrogenic diabetes
insipidus increased renal concentrating ability and reduced polyuria. They
conclude that amiloride can be useful in treating lithium-induced
nephrogenic diabetes insipidus and merits future randomized clinical
trials.
Abstract Teaser