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Hypernatremia: correction rate and hemodialysis
Saima Nur1, Yasir Khan2, Saadia Nur3
1Wellesley College, 106 Central Street, Wellesley, MA 02481, USA.
Case Reports in Medicine
|November 29, 2014
Summary
Severe hypernatremia (serum sodium > 152 mEq/L) is life-threatening. Hemodialysis effectively corrected extreme hypernatremia in an elderly patient, avoiding neurological complications despite rapid sodium correction.
Area of Science:
- Nephrology
- Internal Medicine
- Critical Care Medicine
Background:
- Severe hypernatremia, defined as serum sodium > 152 mEq/L, carries a high mortality rate (≥60%).
- Altered mental status is a common presentation of severe hypernatremia.
Purpose of the Study:
- To report a case of severe hypernatremia managed with hemodialysis.
- To highlight the safety and efficacy of hemodialysis in correcting severe hypernatremia without neurological sequelae.
Main Methods:
- A case report of an 85-year-old male presenting with severe hypernatremia (serum sodium 188 mmol/L) and altered consciousness.
- Management involved intensive care unit admission, suboptimal fluid repletion, followed by hemodialysis for hypernatremia correction.
Main Results:
- Initial fluid repletion resulted in minimal sodium correction (1 mEq/L over 14 hours).
- Hemodialysis rapidly decreased serum sodium by >20 mEq/L within 2 hours.
- The patient experienced no neurological complications and returned to baseline mental status upon discharge.
Conclusions:
- Hemodialysis is an effective and safe modality for correcting severe hypernatremia, even with rapid correction rates.
- This case demonstrates that rapid sodium correction via hemodialysis can be achieved without inducing neurological complications in severe hypernatremia.
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