A Case of Continuous Venovenous Hemofiltration for Anuric Acute Kidney Injury With Severe Hyponatremia: A Simple Method Involving Flexible Adjustment of Sodium Replacement Solution

摘要

D ialysis therapy for patients with severe hypona- tremia is challenging because rapid correction ofthe serum sodium concentration may lead to osmoticdemyelination syndrome (ODS).1 Gradual correction ofhyponatremia is recommended to prevent hazardoussequelae.2,3 Continuous venovenous hemofiltration(CVVH) with low-sodium replacement solution can beused to prevent rapid correction of the serum sodiumconcentration;4 however, preparation of low-sodiumreplacement solution by dilution is difficult and isnot recommended. We developed the “FlexNa”method, which involves flexible adjustment of thesodium concentration of commercially availablereplacement fluid; it assures provision of CVVH withoutaffecting the patient’s serum sodium concentration. Wepresent a case of acute kidney injury concomitant withsevere hyponatremia and hyperkalemia, which wastreated successfully with CVVH using this FlexNamethod.