Can schizophrenia patients with water intoxication undergo hemodialysis sustainably?

Abstract

We experienced three cases in which schizophrenia patients with water intoxication underwent hemodialysis. The patients were admitted to our hospital and underwent hemodialysis. However, they could not undergo water restriction and exhibited weight gain of 10-30% and hyponatremia. Within one year of admission, they died because of volume expansion. In these cases, we had to consider the administration of diuretics, such as tolvaptan, to maintain appropriate urinary output, and the severe hyponatremia seen in case 3 required careful dialysate preparation. Water intoxication is difficult to treat in schizophrenia patients, and performing hemodialysis sustainably is challenging in such cases.