title: [Successful treatment of extreme hypernatremia by continuous veno-venous hemodiafiltration].
abstract: Extreme hypernatremia in intensive care unit are frequently associated with a poor prognosis and their treatment, when associated with acute renal failure, is not consensual. We report the case of a 39-year-old man admitted in our intensive care unit for coma who presented extreme hyperosmolar hypernatremia (sodium 180 mmol/L, osmolarity 507 mOsm/L) associated with acute renal failure (urea 139.3 mmol/L, creatinine 748 μmol/L) and many other metabolic abnormalities. He was treated with hypotonic fluid administration and continuous renal replacement therapy (veno-venous hemodiafiltration) using an industrial dialysate fluid. Natremia was controlled by modulating intravenous water and sodium intake according to biological data. After 10 days, continuous renal replacement therapy was stopped and neurological exam was normal. Continuous veno-venous hemodiafiltration may be useful for treatment of extreme hypernatremia by allowing gradual correction of fluid and electrolyte disorders.
authors.affiliation: Pôle réanimation-anesthésie-Samu, réanimation chirurgicale, CHU Charles Nicolle, 1, rue de Germont, 76031 Rouen, France. Electronic address: mikhael.giabicani@gmail.com.
authors.forename: Mikhael
authors.initials: M
authors.lastname: Giabicani
authors.affiliation: Pôle réanimation-anesthésie-Samu, réanimation chirurgicale, CHU Charles Nicolle, 1, rue de Germont, 76031 Rouen, France.
authors.forename: Pierre-Gildas
authors.initials: PG
authors.lastname: Guitard
authors.affiliation: Service de néphrologie, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Guerrot
authors.affiliation: Service de néphrologie, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France.
authors.forename: Steven
authors.initials: S
authors.lastname: Grangé
authors.affiliation: Pôle réanimation-anesthésie-Samu, réanimation chirurgicale, CHU Charles Nicolle, 1, rue de Germont, 76031 Rouen, France.
authors.forename: Lauranne
authors.initials: L
authors.lastname: Teule
authors.affiliation: Pôle réanimation-anesthésie-Samu, réanimation chirurgicale, CHU Charles Nicolle, 1, rue de Germont, 76031 Rouen, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Dureuil
authors.affiliation: Pôle réanimation-anesthésie-Samu, réanimation chirurgicale, CHU Charles Nicolle, 1, rue de Germont, 76031 Rouen, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Veber
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications / Q000628:therapy*; D000328:Adult; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D006955:Hypernatremia / Q000628:therapy*; D008297:Male; D012964:Sodium / Q000097:blood*; D014883:Water-Electrolyte Imbalance / Q000150:complications / Q000628:therapy
chemical_list: D012964:Sodium
keywords: Acute renal failure; Continuous renal replacement therapy; Hypernatremia; Hypernatrémie extrême; Hyperosmolarity; Hyperosmolarité; Hémodiafiltration veino-veineuse continue; Insuffisance rénale aiguë; Rhabdomyolyse; Rhabomyolysis; Veno-venous hemodiafiltration; Épuration extra-rénale