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A Proposed Approach to the Dialysis Prescription in Severely Hyponatremic Patients with End‐Stage Renal Disease
Author(s) -
Wendland Erik M.,
Kaplan Andre A.
Publication year - 2011
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.1525-139x.2011.00981.x
Subject(s) - medicine , end stage renal disease , medical prescription , dialysis , intensive care medicine , end stage kidney disease , stage (stratigraphy) , kidney disease , disease , urology , pharmacology , paleontology , biology
Patients with renal failure and severe hyponatremia present a therapeutic dilemma. Conventional hemodialysis is necessary to correct blood chemistries and volume overload, yet it may raise serum sodium (Na) too quickly, potentially resulting in osmotic demyelination syndrome. We present the case of a patient who presented with renal failure requiring dialysis and also with a serum Na of 112 mEq/l. Using a dialysate Na concentration of 130 mEq/l and by limiting the blood flow to 50 ml/minute, we were able to raise her serum Na by only 2 mEq/l/hour during her hemodialysis treatment and thus control both the rate and total change in the patient’s serum Na.