Download Lithium intoxication

H.D for lithium intoxication (3)
• Lithium clearance with hemodialysis ranges from 70 to 170
mL/min, compared to normal renal clearance of 10 to 40
mL/min (due to extensive reabsorption of lithium in the
proximal tubules), and only 15 mL/min with peritoneal
dialysis.
• Lithium equilibrates slowly between the extracellular and
intracellular fluids. As a result, a rebound increase in serum
lithium levels occurs after the cessation of hemodialysis, as
intracellular lithium diffuses into the extracellular space.
• Continued gastrointestinal drug absorption may contribute
to the rebound effect. Therefore, it is generally
recommended that a serum lithium concentration be
measured six hours after hemodialysis to confirm that levels
are decreasing.
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