This report describes a 4-month-old infant with multisystem organ failure who developed severe hypernatremia (sodium 168 mEq/l) due to rapid free water removal associated with acute peritoneal dialysis instituted for fluid overload. The current report describes the pathophysiology of the hypernatremia, and its correction by low-sodium hypertonic peritoneal dialysis without compromising ultrafiltration or supplementing with free water. Although peritoneal dialysis can cause hypernatremia, a modified solute concentration in the dialysate can treat the hypernatremia successfully. This report describes a child with multi-system organ failure due to cardiogenic shock who developed severe hypernatremia secondary to aggressive fluid removal from acute peritoneal dialysis to treat anasarca. A mechanism for the development of hypernatremia is proposed. In addition, a method to adjust the solute concentration of the dialysate is proposed to effect successful therapy without compromising fluid removal or providing additional free water.
- Critically ill
- Peritoneal dialysis
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health