Severe Hypernatremia During Continuous Hemofiltration in an End-Stage Renal Disease (ESRD) Patient From the Kingdom of Saudi Arabia: A Case Report and Updated Review

We report a case of a 74-year-old female with end-stage renal disease (ESRD) on maintenance hemodialysis who was admitted with community-acquired pneumonia and decreased level of consciousness. She required intubation and was transferred to the intensive care unit, where continuous renal replacement therapy (CRRT) was initiated. Her initial serum sodium was markedly elevated at 154 mmol/L. Careful adjustment of dialysate and replacement fluid sodium concentrations allowed gradual correction, avoiding cerebral edema or osmotic demyelination. This case highlights the importance of individualized CRRT prescription and close biochemical monitoring to achieve safe sodium correction in critically ill patients.