Here is an excellent article that goes into detail about lithium and kidney disease. There is clearly not enough research to verify the risk of ESRD and lithium use. That is why I requested an ongoing relationship with Mayo just in case I get to the ESRD place. If I need a transplant, that's where I want to go. My local nephrologist kept telling me "No worries, you'll live to 100" which is one of the reasons I made the appointment at Mayo. There is no treatment for damaged kidneys from lithium use. But I didn't want to be coddled into thinking there's no risk.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537577/
"There are conflicting studies in this article. There is not enough research.
Discrepancies among studies were largely due to methodological differences such as varied parameters to assess renal function and definitions of renal impairment, short-term follow-up, a lack of patients on long-term lithium therapy, combining high-risk and low-risk groups, choice of control group (healthy v. psychiatric patients), and an inability to control the confounding variables. Definitive data on the magnitude of the risk are still lacking. Moreover, in the absence of any pathognomonic histological or biochemical changes, lithium-associated CKD remains a diagnosis of exclusion."