Extreme hyponatremia presents unique challenges during hemodialysis treatment. While conventional dialysis machines are typically limited to a minimum sodium concentration of 130 mmol/L, Continuous Renal Replacement Therapy (CRRT) solutions generally contain 140 mmol/L. For patients with extreme hyponatremia, a lower dialysate sodium concentration is preferred to prevent dangerously rapid increases in serum sodium levels.
This calculator provides guidance for selecting appropriate replacement fluid volume and sodium composition, based in part on research findings.
A 50-year-old woman presents with:
Using CRRT with:
The calculator recommends either:
Reference:
Management of Severe Hyponatremia with Continuous Renal Replacement Therapies.
Clin J Am Soc Nephrol. 2018 May 7;13(5):787-789.
doi: 10.2215/CJN.13281117