Excessive ultrafiltration, intra-dialytic hypotension, electrolyte-mineral disturbances, hypo-osmolality
are the most frequent causes.
While the workup shows hypernatremia, serum hypo-osmolality, urine osmolality >100 mosm/kg (serum osmolality is lower than urine osmolality), decrease urine output, normal urine sodium concentration and potassium and acid base concentration which are going with SIADH criteria.
The SIADH occur when urine osmolality of more than 100 msom/kg in the context of plasma hypo-osmolality is sufficient to confirm ADH excess.
5 mEq/L; hyperosmolality, osmolality > 295 mOsm/kg; normoosmolality, 285 mOsm/kg [less than or equal to] osmolality [less than or equal to] 295 mOsm/kg; and hypo-osmolality
, osmolality < 285 mOsm/kg.
These neurotoxic effects result from an influx of water into brain cells in response to the acute onset of hypo-osmolality
Although it is classically associated with hyponatraemia, it can also cause hyperglycinaemia, hyperammonaemia or simply hypo-osmolality
, depending on the irrigation fluid being used.
The simple tubular kidney was no longer adequate to maintain the internal osmotic environment--it could not eliminate enough water, and too much solute was lost, so the organism succumbed to extreme hypo-osmolality