Wcn24-803 Sever Symptomatic Chronic Hyponatremia With Sever Acidosis: A Challange to Dialyze

Patients with chronic hyponatremia, especially those with a serum sodium level below 120 mEq/l, pose a significant challenge in both acute and chronic HD settings. In cases where the hyponatremia gradually develops over several days or weeks, the brain cells adapt to reduce the risk of cerebral edema by excreting organic osmolytes. However, this adaptation makes brain cells vulnerable to osmotic demyelination syndrome, such as pontine and extrapontine myelinolysis, if the serum sodium level is corrected too rapidly.