tag:blogger.com,1999:blog-4230162007222918868.post8316191413101693515..comments2023-09-19T05:50:03.130-04:00Comments on Renal Fellow Network: SEVERE CHRONIC HYPONATREMIA: A Pathophysiological Rumination.Gearoid McMahonhttp://www.blogger.com/profile/08049723797363526138noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-4230162007222918868.post-30171745571294605612014-11-26T02:12:09.294-05:002014-11-26T02:12:09.294-05:00Ashraf: interesting question. I've never encou...Ashraf: interesting question. I've never encountered such a case where chronic severe hyponatremia needed correction in an active-CVVHD case. So many variables in such a situation but the dialysate composition is often difficult to change and the need for clearance will also play into the dialysate flow rates. <br />However, I'm assuming that most such patients will be anuric or oliguric which will take the major variable of urine output out of the picture. <br />I'm guessing that in such a patient, I would bolus for initial rapid correction or 2-4 mEq/L for symptoms but check Na very frequently the first few hours to see how the dialysis is affecting Na concentration and then titrate 3% saline accordingly. I would probably check Na hourly for the first 3-4 hours to make sure there are no sudden fluctuations and then q2-3 hr for sometime thereafter.Hashim Mohmandnoreply@blogger.comtag:blogger.com,1999:blog-4230162007222918868.post-6228403493267155842014-11-10T00:38:23.779-05:002014-11-10T00:38:23.779-05:00Great post. I am curious to know your approach to ...Great post. I am curious to know your approach to severe hyponatremia in the setting of CRRT. How do you safely provide CVVHD or CVVHDF without overcorrection.Anonymoushttps://www.blogger.com/profile/16532354222984731226noreply@blogger.comtag:blogger.com,1999:blog-4230162007222918868.post-50513821254247737742014-11-04T01:18:08.782-05:002014-11-04T01:18:08.782-05:00thank you dear Hashim Mohammed for making Hyponatr...thank you dear Hashim Mohammed for making Hyponatremia management so much more clear and concise. Really enjoyed all your articles. Thank you for sharing your knowledge. Looking forward for more articles from youAnonymoushttps://www.blogger.com/profile/02669389073249214976noreply@blogger.comtag:blogger.com,1999:blog-4230162007222918868.post-64549618156395162192014-10-31T21:03:40.085-04:002014-10-31T21:03:40.085-04:00Thank you for those clear and concise articles.Thank you for those clear and concise articles.Willhttps://www.blogger.com/profile/01718123016480695979noreply@blogger.com