婴儿急性肾损伤伴严重低钠血症的低剂量连续肾脏替代治疗和外周 D5W 管理。
Management of severe hyponatremia with low-dose continuous kidney replacement therapy and peripheral D5W in an infant with acute kidney injury.
机构信息
Pediatric Nephrology, Cohen Children's Medical Center, New Hyde Park, New York, USA
Pediatric Nephrology, Children's Hospital at Montefiore, Bronx, New York, USA.
出版信息
BMJ Case Rep. 2021 Jul 2;14(7):e240308. doi: 10.1136/bcr-2020-240308.
We report a 7-month-old female infant who presented with anuric acute kidney injury and severe hyponatremia (serum sodium 110 mEq/L). The patient was treated with low-dose continuous kidney replacement therapy (CKRT), that is, 85% of total clearance dose divided equally between normonatric (Na 140 mEq/L) replacement and dialysate fluids. The remaining 15% of the clearance was provided by peripheral infusion of dextrose 5% (D5W). The patient's sodium was maintained between 119 mEq/L and 121 mEq/L for the first 24 hours of CKRT. Over the next 2 days, the rate of D5W infusion was slowly decreased while replacement and dialysis flow rates were proportionately increased. Serum sodium was normalised by day 2 of the therapy. The patient had no neurologic sequelae associated with this therapy.
我们报告了一例 7 个月大的女性婴儿，她因无尿性急性肾损伤和严重低钠血症（血清钠 110mEq/L）而就诊。该患者接受小剂量连续肾脏替代治疗（CKRT），即总清除剂量的 85%在等渗（Na 140mEq/L）置换液和透析液之间等分，其余 15%的清除量通过外周输注 5%葡萄糖（D5W）提供。在 CKRT 的最初 24 小时内，患者的钠浓度维持在 119mEq/L 和 121mEq/L 之间。在接下来的 2 天内，逐渐减少 D5W 输注速度，同时相应增加置换液和透析液流速。治疗第 2 天，血清钠恢复正常。该患者在接受这种治疗后没有出现与治疗相关的神经后遗症。
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