Journal
INTERNAL MEDICINE
Volume 60, Issue 16, Pages 2645-2649Publisher
JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.6667-20
Keywords
hyponatremia; acute kidney injury; 3% saline bolus administration; hemodialysis; osmotic demyelination syndrome
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The case describes a 60-year-old man presenting with lightheadedness, severe hyponatremia, and acute kidney injury, who stabilized after treatment, suggesting that intermittent hemodialysis may also be used for management.
A 60-year-old man presented to the emergency department with lightheadedness. He had severe hyponatremia (109 mEq/L) complicated by acute kidney injury (AKI) (serum creatinine: 9.08 mg/dL). Because he was somnolescent, his hyponatremia was initially treated by administering a 130-mL bolus of 3% saline 2 to 5 times per day for 5 days. He subsequently underwent intermittent hemodialysis without any neurological problems. Previous reports have described patients with hyponatremia and AKI being treated with continuous renal replacement therapy. However, our strategy might be a feasible, low-cost treatment strategy of treating patients with hyponatremia and AKI who do not require immediate hemodialysis.
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