Continuous Kidney Replacement Therapy With Adjusted Dialysate Sodium Concentration for Severe Hyponatremia in Beer Potomania: A Case Report

TL;DR

A patient with severe low sodium and kidney injury was successfully treated using a dialysis method that carefully adjusted sodium levels to avoid complications.

Contribution

This case report demonstrates the successful use of CKRT with adjusted dialysate sodium for severe hyponatremia in beer potomania with AKI.

Findings

CKRT with adjusted dialysate sodium allowed gradual correction of severe hyponatremia without causing osmotic demyelination syndrome.

The patient was successfully taken off hemodialysis after 12 days of treatment.

The case highlights the effectiveness of tailored CKRT in managing complex electrolyte and kidney disorders.

Abstract

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.

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