Pediatric Nephrology, Cohen Children's Medical Center, New Hyde Park, New York, USA
Pediatric Nephrology, Children's Hospital at Montefiore, Bronx, New York, USA.
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。
