A patient who is on chronic lithium therapy for bipolar disorder presents with renal functional impairment.

Fig. 60.1 (A,B) Select postcontrast CT images demonstrate numerous small, low-attenuation lesions distributed throughout both kidneys.

Renal changes from lithium toxicity

• Autosomal dominant polycystic kidney disease (ADPKD)
  
• Acquired cystic disease secondary to chronic renal failure or long-term dialysis
  
• Glomerulocystic kidney disease
  
• Medullary cystic disease