Management of dysnatremias with continuous renal replacement therapy

Semin Dial. 2021 Nov;34(6):472-479. doi: 10.1111/sdi.12983. Epub 2021 Jul 3.

Abstract

Disorders of serum sodium concentration are common in critically ill patients who may have concomitant acute kidney injury, chronic kidney disease, or end-stage kidney disease. Many of these patients may require customized serum sodium level management with dialysis which, if not strictly controlled, can lead to significant complications. Thus, controlled correction of the serum sodium level is necessary to avoid the development of osmotic demyelination syndrome in hyponatremic patients and dialysis disequilibrium syndrome in hypernatremic patients. Continuous renal replacement therapy offers unique benefits through the ability to slowly and safely correct dysnatremias that can be tailored to specific patient needs and should be considered in select patients.

Keywords: CRRT; dialysis; dysnatremia; hypernatremia; hyponatremia.

MeSH terms

  • Continuous Renal Replacement Therapy*
  • Humans
  • Hypernatremia* / complications
  • Hypernatremia* / therapy
  • Hyponatremia* / complications
  • Hyponatremia* / therapy
  • Renal Dialysis / adverse effects
  • Renal Replacement Therapy / adverse effects
  • Sodium

Substances

  • Sodium