Renal toxicity is more common in patients on chronic lithium treatment. Toxicity includes impaired urinary concentrating ability, nephrogenic
diabetes insipidus (the most common cause of drug-induced NDI), sodium-losing nephritis, nephrotic syndrome along with other manifestations.
The severity of lithium toxicity is often divided into the following three grades: mild, moderate, and severe.
Mild symptoms: nausea, vomiting, lethargy, tremor, and fatigue (Serum lithium concentration between 1.5-2.5 mEq/L)
Moderate intoxication: confusion, agitation, delirium, tachycardia, and hypertonia (serum lithium concentration between 2.5-3.5 mEq/L)
Severe intoxication: Coma, seizures, hyperthermia, and hypotension (serum lithium concentration (less than 3.5 mEq/L)
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