Journal
RENAL FAILURE
Volume 29, Issue 5, Pages 635-638Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/08860220701392314
Keywords
central pontine myelinolysis; hyponatremia; hemodialysis
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Osmotic demyelination syndrome, a well-known entity, is characterized by demyelination in the pons and extrapontine areas. Rapid correction of chronic hyponatremia is its most important cause. This report presents a 52-year-old man with uremia and hyponatremia. Dernyelination syndrome developed after the first hemodialysis session. Brain images showed central pontine myelinolysis and extrapontine myelinolysis. This case emphasizes the fact that demyelination syndrome can occur when hyponatremia is corrected too rapidly, even in uremic patients. Lowering dialysate sodium with multiple, short durations of hemodialysis at a low blood flow rate should be prescribed during hemodialysis in select hyponatremic patients.
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