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지속적인 신대체 요법으로 조기 치료된 만니톨 유도 핍뇨성 급성신부전 1예

A Case of Oliguric Mannitol Induced Acute Kidney Injury Early Treated by Continuous Renal Replacement Therapy

고신대학교 의과대학 학술지 2014년 29권 1호 p.59 ~ 62
황경오, 강여진, 배은진, 장세호, 박동준,
소속 상세정보
황경오 ( Hwang Kyung-O ) - 경상대학교 의학전문대학원 내과학교실
강여진 ( Kang Yeo-Jin ) - 경상대학교 의학전문대학원 내과학교실
배은진 ( Bae Eun-Jin ) - 경상대학교 의학전문대학원 내과학교실
장세호 ( Chang Se-Ho ) - 경상대학교 의학전문대학원 내과학교실
박동준 ( Park Dong-Jun ) - 경상대학교 의학전문대학원 내과학교실

Abstract


We report oliguric mannitol-induced acute kidney injury (AKI) early treated by continuous renal replacement therapy. A 70-year-old woman was admitted to the Department of Neurology with diagnosis of acute intracranial hemorrhage. Mannitol was infused for intracranial pressure control. At admission third day, urine output was abruptly decreased to 57 ml during first 6 hours and blood urea nitrogen (BUN) and serum creatinine was increased to 54.2 mg/dL and 5.3 mg/dL respectively. Plasma osmolality was 340 mOsm/kg and osmolar gap was 70. Mannitol was immediately withdrawn and continuous renal replacement therapy (CRRT) was performed to remove mannitol rapidly. Urine output was increased 6 hours later after continuous veno-veno hemodiafiltration (CVVHDF) start. BUN and creatinine was decreased to 21.4 and 1.2 mg/dL at admission ninth day. Mannitol can develop oliguric AKI and CRRT may be of more benefit than conventional hemodialysis in the case of increased intracranial pressure.

키워드

Acute Kidney Injury; Mannitol; Oliguria; Renal Replacement Therapy

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