Acute peritoneal dialysis as both cause and treatment of hypernatremia in an infant

M. L. Moritz, M. del Rio, G. A. Crooke, L. P. Singer

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


This report describes a 4-month-old infant with multisystem organ failure who developed severe hypernatremia (sodium 168 mEq/l) due to rapid free water removal associated with acute peritoneal dialysis instituted for fluid overload. The current report describes the pathophysiology of the hypernatremia, and its correction by low-sodium hypertonic peritoneal dialysis without compromising ultrafiltration or supplementing with free water. Although peritoneal dialysis can cause hypernatremia, a modified solute concentration in the dialysate can treat the hypernatremia successfully. This report describes a child with multi-system organ failure due to cardiogenic shock who developed severe hypernatremia secondary to aggressive fluid removal from acute peritoneal dialysis to treat anasarca. A mechanism for the development of hypernatremia is proposed. In addition, a method to adjust the solute concentration of the dialysate is proposed to effect successful therapy without compromising fluid removal or providing additional free water.

Original languageEnglish (US)
Pages (from-to)697-700
Number of pages4
JournalPediatric Nephrology
Issue number9
StatePublished - Jan 1 2001


  • Critically ill
  • Edema
  • Hypernatremia
  • Infant
  • Peritoneal dialysis
  • Sodium

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology


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