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This topic will focus on the treatment of hypernatremia induced by water loss, which is the most common cause. The treatment of hypernatremia in patients with impaired thirst, with or without arginine vasopressin disorders, and with primary sodium overload will also be reviewed.
Untreated hypernatremia is a hallmark of low-quality, amateur ICU care. Hypernatremia usually won't improve on its own (it usually represents a water deficit that will tend to get worse over time). Even mild hypernatremia (e.g. sodium 146-148 mEq/L) may cause discomfort and shouldn't be ignored.
Total body water loss relative to solute loss is the most common reason for developing hypernatremia. Hypernatremia is usually associated with hypovolemia, which can occur in conditions that cause combined water and solute loss, where water loss is greater than sodium loss or free water loss.
Because sodium and its anions make up most of the effective osmoles in the extracellular fluid, a high plasma sodium concentration (hypernatremia) indicates hypertonicity and a decrease in cell volume [1,2]. In most cases, hypernatremia results from water depletion.
Hypovolemic hypernatremia. Hypernatremia associated with hypovolemia occurs with sodium loss accompanied by a relatively greater loss of water from the body. Common extrarenal causes include most of those that cause hyponatremia and volume depletion.
Hyponatremia and hypernatremia are common findings in the inpatient and outpatient settings. Sodium disorders are associated with an increased risk of morbidity and mortality. Plasma osmolality...
Hypernatremia, a condition characterized by elevated sodium levels in the blood, can occur in conjunction with hypovolemia, where the body experiences a significant loss of fluid. This complex medical scenario requires careful understanding and management to avoid serious health consequences.
Loss of volume can lead to circulatory problems (eg, tachycardia, hypotension). Acute symptomatic hypernatremia, defined as hypernatremia occurring in a documented period of less than 24 hours,...
Hypernatremia represents a deficit of water relative to sodium and can result from a number of causes, including free water losses, inadequate free water intake, and, more rarely, sodium overload. Unlike hyponatremia, hypernatremia is always associated with serum hyperosmolality.
Hypervolemic hyponatremia is treated primarily by managing the underlying cause (e.g., heart failure, cirrhosis) and free water restriction. Hypernatremia is less common than hyponatremia.