Akatsuka Masayuki, Tatsumi Hiroomi, Osanami Arata, Nakamura Yuki
Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, JPN.
Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, JPN.
Cureus. 2024 Aug 14;16(8):e66834. doi: 10.7759/cureus.66834. eCollection 2024 Aug.
Beer potomania is a condition characterized by severe hyponatremia in chronic alcoholics with poor nutritional intake. When complicated by acute kidney injury (AKI), it presents a significant management challenge. We report a case of a 32-year-old male with a history of alcoholism who presented with malaise, nausea, and vomiting. Laboratory tests revealed severe hyponatremia (serum sodium 104 mEq/L) and AKI. Conventional treatment approaches posed risks of overcorrection and osmotic demyelination syndrome (ODS). We implemented continuous kidney replacement therapy (CKRT) with meticulously adjusted dialysate sodium concentrations. This approach enabled gradual, controlled correction of serum sodium without precipitating ODS. The patient was successfully liberated from hemodialysis on the twelfth day of illness. Our findings highlight the potential of CKRT as an effective treatment modality for severe hyponatremia in beer potomania with AKI, offering a means of gradual sodium correction while addressing renal dysfunction. This case underscores the importance of tailored management strategies in complex clinical scenarios involving electrolyte imbalances and kidney injury.
啤酒狂饮低钠血症是一种在营养摄入不良的慢性酗酒者中表现为严重低钠血症的病症。当并发急性肾损伤（AKI）时，它带来了重大的管理挑战。我们报告一例32岁有酗酒史的男性病例，该患者出现不适、恶心和呕吐。实验室检查显示严重低钠血症（血清钠104 mEq/L）和急性肾损伤。传统治疗方法存在过度纠正和渗透性脱髓鞘综合征（ODS）的风险。我们实施了连续肾脏替代疗法（CKRT），并精心调整透析液钠浓度。这种方法能够逐步、可控地纠正血清钠，而不会引发渗透性脱髓鞘综合征。患者在患病第12天成功脱离血液透析。我们的研究结果凸显了连续肾脏替代疗法作为治疗啤酒狂饮低钠血症合并急性肾损伤导致的严重低钠血症的有效治疗方式的潜力，提供了一种逐步纠正钠水平同时解决肾功能障碍的方法。该病例强调了在涉及电解质失衡和肾损伤的复杂临床场景中制定个性化管理策略的重要性。
