title: Continuous venovenous hemofiltration using customized replacement fluid for acute kidney injury with severe hypernatremia.
abstract: The initiation of continuous renal replacement therapy (CRRT) in acute kidney injury (AKI) with severe hypernatremia is challenging since sodium concentrations in commercial replacement fluid (RF) and dialysate solutions are usually fixed at 140 mEq/L. We present a case of AKI with severe hypernatremia successfully treated with CRRT using commercial RF solutions customized to prevent rapid correction of hypernatremia. None of the few case reports published on hypernatremia and AKI requiring CRRT have included formulas to help modulate the sodium content in the solutions. We present an equation to facilitate adjustment of the sodium concentration in this setting.
authors.affiliation: Department of Medicine, Division of Nephrology , Sacre-Coeur Hospital of Montreal , Montreal, Quebec , Canada.
authors.forename: François
authors.initials: F
authors.lastname: Paquette
authors.affiliation: Department of Medicine, Division of Nephrology , Sacre-Coeur Hospital of Montreal , Montreal, Quebec , Canada.
authors.forename: Rémi
authors.initials: R
authors.lastname: Goupil
authors.affiliation: Department of Medicine, Division of Nephrology , Sacre-Coeur Hospital of Montreal , Montreal, Quebec , Canada.
authors.forename: François
authors.initials: F
authors.lastname: Madore
authors.affiliation: Department of Medicine, Division of Nephrology , Sacre-Coeur Hospital of Montreal , Montreal, Quebec , Canada.
authors.forename: Stéphan
authors.initials: S
authors.lastname: Troyanov
authors.affiliation: Department of Medicine, Division of Nephrology , Sacre-Coeur Hospital of Montreal , Montreal, Quebec , Canada.
authors.forename: Josée
authors.initials: J
authors.lastname: Bouchard
keywords: acute kidney injury; acute renal failure; continuous renal replacement therapy; dialysis; hypernatremia