Table 2.

Clinical management of lithium treatment to minimize the risk of chronic kidney disease

- Regular monitoring of renal function, as measured by eGFR, every three months to yearly for most patients

- Increase frequency of measurements in patients who show a decrease in eGFR

- Optimally, 12 h lithium levels 0.6–0.8 mEq/L (see Nolen et al., 2019)

- Once daily lithium administration (if in the first five years of lithium treatment)

- Avoid lithium toxicity episodes (e.g. by regular patient and caregiver education including the risk constellations for intoxication and how to avoid it)

- Aggressive treatment of other comorbid disorders potentially affecting renal function such as diabetes mellitus and hypertension