Continuous venovenous hemodiafiltration in hypernatremic hyperglycemic nonketotic coma.

Abstract

Rapid changes in serum sodium concentration can result in adverse neurological outcome. The gradual correction of hypernatremia in the setting of acute renal failure can be difficult to achieve. We describe an obese female teenager who presented with severe hypernatremia, hyperosmolar hyperglycemic nonketotic coma, acute renal failure, and rhabdomyolysis. Her hypernatremia and other serum chemistries were gradually corrected by repeatedly adjusting the dialysate electrolyte composition used during continuous venovenous hemodiafiltration. She had a full recovery of her renal function. She does not have clinical neurological sequelae from hypernatremia during a 1-year follow-up period.

• Authors: Jen-Jar Lin, Daniel W McKenney, Cathy Price, R Ray Morrison, William E Novotny
• Journal: Pediatric nephrology (Berlin, Germany) (Pediatr Nephrol) Vol. 17 Issue 11 Pg. 969-73 (Nov 2002) ISSN: 0931-041X [Print] Germany
• PMID: 12432445 (Publication Type: Case Reports, Journal Article)

Chemical References

• Sodium

Topics

• Acidosis (complications)
• Acute Kidney Injury (complications)
• Child
• Female
• Hemodynamics (physiology)
• Hemofiltration
• Humans
• Hyperglycemic Hyperosmolar Nonketotic Coma (complications, physiopathology, therapy)
• Obesity (complications)
• Osmolar Concentration
• Rhabdomyolysis (complications)
• Sodium (blood)
• Water-Electrolyte Balance (physiology)