Treating Severe Hyponatremia and Renal Failure with Automated Peritoneal Dialysis

Abstract

Severe hyponatremia and renal failure requiring renal replacement therapy pose a therapeutic challenge. Hemodialysis to correct volume overload, azotemia, and abnormal electrolyte levels will result in rapid correction of serum sodium concentration and place the patient at risk for osmotic demyelination syndrome. We present a patient with acute kidney injury and severe hypotonic hyponatremia (serum sodium<115 mEq/L) who was treated successfully with Automated Peritoneal Dialysis(APD).Previous experiences of using continuous venovenous hemofiltration successfully have been documented,,where sodium correction rate is regulated by intricate single pool sodium kinetic modelling, but there are no reports of peritoneal dialysis in these situations. In our case, bedside Tenchoff catheter placement and cycler PD used. We found that APD can be a cost effective safe, accurate and easy alternate treatment in combined hyponatremia and renal failure requiring dialysis.