Circulation

Dehydration is common in patients with chronic lithium toxicity and adequate fluid replacement is essential in all patients. Intravenous fluid rehydration with sodium chloride 0.9% is the first-line treatment for dehydration and enhances lithium elimination in patients with normal kidney function.

Many patients taking long-term lithium therapy have lithium-induced nephrogenic diabetes insipidus and require larger than normal volumes of fluid to replace their unusually high urine output.