Most common renal sequel of lithium toxicity is ?

Ans. is 'a' i.e., Nephrogenic DM Lithium associated renal toxicity The use of lithium salts for the treatment of manic-depressive illness may have several renal sequelae, the most common of which is nephrogenic diabetes insipidus manifesting as polyuria and polydipsia. Lithium accumulates in principal cells of the collecting duct by entering through the epithelial sodium channel (ENaC), where it inhibits glycogen synthase kinase 3 and down- regulates vasopressin-regulated aquaporin water channels. Less frequently, chronic tubulointerstitial nephritis develops after prolonged (greater than 10-20 years) lithium use and is most likely to occur in patients that have experienced repeated episodes of toxic lithium levels.