Saline-induced dilutional acidosis in a maintenance hemodialysis patient.
A patient with end-stage renal disease developed severe hyperchloremic acidosis (venous serum total CO2 level of 10 mmol/L) after treatment with 16 L of isotonic saline. Analysis of this case and published literature indicates that dilutional acidosis may result when very large volumes of isotonic saline are administered intravenously, especially in patients with impaired or absent renal function.
Mirza
B I
BI
Department of Medicine, Veterans Affairs Hospital, Hines, Illinois 60141, USA.
Sahani
M
M
Leehey
D J
DJ
Patel
S B
SB
Yang
V L
VL
Ing
T S
TS
D000138:Acidosis / Q000209:etiology*; D000368:Aged; D002712:Chlorides / Q000097:blood; D005440:Fluid Therapy / Q000009:adverse effects*; D006438:Hemodilution / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D006435:Renal Dialysis / Q000379:methods; D012772:Shock, Septic / Q000175:diagnosis / Q000188:drug therapy*; D012965:Sodium Chloride / Q000008:administration & dosage*; D014883:Water-Electrolyte Imbalance
D002712:Chlorides; D012965:Sodium Chloride