A true dialytic urgency: lithium intoxication

Abstract Lithium carbonate is a drug widely used in Colombia for the treatment of various psychiatric pathologies such as treatment in patients with bipolar affective disorder, however its narrow therapeutic index predisposes to the occurrence of acute poisoning, unlikely to happen but could be fatal. It should be said that its diagnosis requires a high rate of suspicion because it presents various clinical manifestations such as neuropsychia-tric symptoms and even mental disorders of an organic type that can be complicated by an acute kidney injury requiring emergency dialysis therapy. We report the case of a patient who presented to the emergency department with alteration in the state of consciousness in whom lithium poisoning was found and who required hemodialysis in an early stage. In conclusion, in a patient with risk factor and therapy with this drug is very important to guide appropriate treatment, and also discard differential diagnosis, in order to avoid fatal consequences.