Open AccessExtreme Neonatal Hypernatremia and Acute Kidney Injury Associated with Failure of Lactation
Author(s) -
Gianfranco Tomarelli,
Daniela Arriagada,
Alejandro Donoso,
Franco Díaz Rubio
Publication year - 2019
Publication title -
journal of pediatric intensive care
Language(s) - English
Resource type - Journals
eISSN - 2146-4618
pISSN - 2146-4626
DOI - 10.1055/s-0039-3400469
Subject(s) - hypernatremia , medicine , peritoneal dialysis , intensive care medicine , dialysis , acute kidney injury , etiology , renal function , sodium , pediatrics , anesthesia , chemistry , organic chemistry
Hypoalimentation is an important cause of hypernatremic dehydration in neonates; however, extreme values of plasma sodium make it necessary to investigate the differential diagnosis. We report the case of a 20-day-old newborn who was admitted with severe hypernatremic dehydration, with plasma sodium of 213 mEq/L and oliguric acute renal failure. The patient was treated with intravenous fluids for correction of dehydration and peritoneal dialysis for adequate sodium correction. During the etiological study, a 10-fold increase in the concentration of sodium in breast milk was detected. Peritoneal dialysis was an effective therapy in the management of the extreme hypernatremia with sodium correction within the recommended rate. At the 1-year follow-up appointment, the child had normal renal function, normal for age psychomotor development, and neurological physical was unremarkable. In conclusion, we report a case of an unusual extreme hypernatremia with discussion of the underlying pathophysiology and, more importantly, the effective treatment with a mixed approach with intravenous fluids and peritoneal dialysis.