Successful Sodium Level Correction with a 3% Saline Bolus before Intermittent Hemodialysis for a Patient with Severe Hyponatremia Accompanied by Acute Kidney Injury

A 60-year-old man presented to the emergency department with lightheadedness. He had severe hyponatremia (109 mEq/L) complicated by acute kidney injury (AKI) (serum creatinine: 9.08 mg/dL). Because he was somnolescent, his hyponatremia was initially treated by administering a 130-mL bolus of 3% saline 2 to 5 times per day for 5 days. He subsequently underwent intermittent hemodialysis without any neurological problems. Previous reports have described patients with hyponatremia and AKI being treated with continuous renal replacement therapy. However, our strategy might be a feasible, low-cost treatment strategy of treating patients with hyponatremia and AKI who do not require immediate hemodialysis.