November 2013

Abnormal kidneys on both sides

Clinical Info

Impaired renal function in a patient treated for psychiatric problems for many years.

Ultrasound Images & Clips

Abnormal kidneys on both sides

Longitudinal image of the right kidney
Longitudinal image of the right kidney
Another longitudinal image of the right kidney
Another longitudinal image of the right kidney
Transverse image of the right kidney
Transverse image of the right kidney
Longitudinal image of the left kidney
Longitudinal image of the left kidney
Another longitudinal image of the left kidney
Another longitudinal image of the left kidney
Longitudinal image of the same patient 10 years earlier
Longitudinal image of the same patient 10 years earlier
Another image made 10 years earlier
Another image made 10 years earlier
MRI
MRI
MRI
Longitudinal image of the right kidney of a 55 year old male patient who also uses lithium for a long time. The kidneys show the same abnomalities
Longitudinal image of the right kidney of a 55 year old male patient who also uses lithium for a long time. The kidneys show the same abnomalities
Transverse image of the right kidney
Transverse image of the right kidney
Longitudinal image of the left kidney
Longitudinal image of the left kidney

Conclusion

Both patients were treated with lithium for many years causing so called lithium kidneys.
The predominant form of chronic renal disease associated with lithium therapy is a chronic tubulointerstitial nephropathy. The image findings of renal disease that distinguish patients treated with lithium from other renal cystic disorders are the presence of distal tubular dilatation and microcysts. These cysts are present in 33%-62% of patients undergoing lithium therapy. They are localized in both the cortex and the medulla. In general, they do not exceed 1-2 mm in diameter. Lithium-associated kidney microcysts are usually echogenic on ultrasound examination because these cysts are lined by cuboidal epithelial cells in a stroma, which is surrounded by fibrosis. This surrounding fibrosis dominates the ultrasound image and appears as echogenic foci. CT and MRI demonstrate the usual appearance of cysts except the size is usually in 1-2mm range and no contrast enahancement is present.


Details

  • Sex: Female
  • Age: 43

Created with

  • Hitachi Ultrasound System