An Infant With Extreme Hypernatremia Treated With Peritoneal Dialysis.
Ping Ling, Rong Tang, Ye Chen et al.
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Case in brief
A 34-day-old, 3.6-kg male infant developed serum sodium >200 mmol/L and multiple organ dysfunction after accidental salt poisoning. Continuous renal replacement therapy was not feasible because of his low body weight and the lack of appropriately sized equipment, so peritoneal dialysis was used as rescue therapy. Within 24 hours, serum sodium fell to 186.7 mmol/L, alongside improvement in metabolic acidosis, coagulopathy, and other organ dysfunction. Peritoneal dialysis was stopped on day 7; the infant was discharged with normal neurological and organ function.
What made this case unusual
The management challenge was extreme hypernatremia in a very low-body-weight infant for whom continuous renal replacement therapy was not feasible; peritoneal dialysis was used as rescue therapy.
Diagnostic / clinical pearl
In this case, peritoneal dialysis was a rescue option for extreme hypernatremia when the infant’s low body weight and unavailable appropriately sized equipment precluded continuous renal replacement therapy.