The use of dialysis bath fluid as a vehicle for a drug with a narrow therapeutic index--lithium chloride.

Case history The patient was a 47-year-old housewife who began RDT in March 1972, at which time she was oedematous, her blood urea was 250 mg/100 ml, her creatinine 22 mg/100 ml and her haemoglobin 5 9 g%. Six weeks after the onset of RDT when the patient's physical condition had improved and her predialysis blood urea was 170 mg/100 ml and her creatinine 14-5 mg/100 ml, she became hypomanic. Four years before RDT the patient had a documented episode of hypomania and a long personal and family history of psychiatric illness. At the time of initiation of haemodialysis the patient had appeared entirely well adjusted, having been employed in a trusted government post until a month before.