What is hypernatremic dehydration?

The hypernatremic dehydration defined by a serum sodium concentration> or = to 150 mmol/l, is a particular form of acute dehydration and constitutes a medical emergency requiring a prompt and adequate diagnosis and management.

How does Hypernatremic dehydration occur?

Hypernatremic (hypertonic) dehydration occurs when the lost fluid contains less sodium than the blood (loss of hypotonic fluid). Relatively less sodium than water is lost.

What is considered Hypernatremic?

Hypernatremia is a common electrolyte problem that is defined as a rise in serum sodium concentration to a value exceeding 145 mmol/L. It is strictly defined as a hyperosmolar condition caused by a decrease in total body water (TBW) relative to electrolyte content.

What is Hyponatremic dehydration?

Hypotonic dehydration (hyponatremia). Hyponatremia is what happens when you have too little sodium in your body. This can happen if you lose electrolytes and fluids together but only replace the lost fluids.

How do you manage Hypernatremic dehydration?

The most cautious approach is to plan a slow correction of the fluid deficit over 48 hours. Following adequate intravascular volume expansion, rehydration fluids should be initiated with 5% dextrose in 0.9% sodium chloride. Serum sodium levels should be assessed every 2-4 hours.

Hypernatremia Explained Clearly - Pathophysiology

What is the most common cause of hypernatremia?

Although hypernatremia is most often due to water loss, it can also be caused by the intake of salt without water or the administration of hypertonic sodium solutions [3]. (See 'Sodium overload' below.) Hypernatremia due to water depletion is called dehydration.

Is hypernatremia life threatening?

Hypernatremia can be fatal, and may cause permanent brain damage if not treated properly. Some studies suggest the mortality rate may be more than 50% in hospitalized patients affected by the disorder.

Can drinking too much water cause hyponatremia?

Water intoxication is a rare phenomenon that occurs due to an excessive intake of water, and when the amount of water intake exceeds that of water excretion in the kidney. As a result, the sodium concentration in the blood is diluted, and hyponatremia develops.

What happens to the brain in hyponatremia?

In acute hyponatremia, sodium levels drop rapidly — resulting in potentially dangerous effects, such as rapid brain swelling, which can result in a coma and death. Premenopausal women appear to be at the greatest risk of hyponatremia-related brain damage.

How fast can you correct hyponatremia?

Goal rate of sodium correction is 6 to 8 mEq/L in 24 hours, 12 to 14 mEq/L in 48 hours. Use hypertonic saline for severe symptomatic hyponatremia.

What are 3 causes of hypernatremia?

What is the main cause of hypernatremia? This condition is often caused by insufficient fluid intake or excessive water loss. Certain health conditions may also increase the risk of hypernatremia, including kidney disease, uncontrolled diabetes, diabetes insipidus, and dementia.

What does hypernatremia do to the brain?

Brain shrinkage induced by hypernatremia can cause vascular rupture, with cerebral bleeding, subarachnoid hemorrhage, and permanent neurologic damage or death. Brain shrinkage is countered by an adaptive response that is initiated promptly and consists of solute gain by the brain that tends to restore lost water.

What does hypernatremia do to the heart?

[6] demonstrated that hypernatremia following acute subarachnoid hemorrhage was associated with adverse cardiac outcomes such as left ventricular contractile dysfunction, elevated cardiac enzymes, pulmonary edema, and death.

How is hypernatremia treated in the elderly?

TREATMENT. If the patient is symptomatic because of severe hyponatremia, it is generally considered safe to raise the serum sodium concentration at a rate of 0.6 to 2.0 mEq per L (0.6 to 2.0 mmol per L) per hour or no more than 12 mEq per L (12 mmol per L) in the first 24 hours.

Does hypernatremia cause hypertension?

Hypernatremia and Diet

But eating too much salt might lead to other health problems, like high blood pressure.

What causes too much sodium in urine?

A higher than normal urine sodium level may be due to: Certain medicines, such as water pills (diuretics) Low function of the adrenal glands. Inflammation of the kidney that results in salt loss (salt-losing nephropathy)

Can you recover from hyponatremia?

Most patients with hypovolemic hyponatremia can be treated successfully with isotonic saline solution (0.9% NaCl), but in the presence of severe symptoms, such as seizures or coma, hypertonic saline infusion is required [7].

What is the most severe complication of hyponatremia?

Hyponatremia can produce a wide range of disturbances involving almost all body systems, but the most relevant and potentially lethal involve the CNS. As noted above, acute severe hyponatremia, if left untreated, causes cerebral edema that can lead to coma, irreversible neurologic damage, and even death [1, 21].

How is hyponatremia treated in the elderly?

Hyponatremia treatments may include changing a medication that affects your sodium level, treating the underlying disease, changing the amount of water you drink or changing the amount of salt in your diet.

Will eating salt help hyponatremia?

In elderly patients with a diet poor in protein and sodium, hyponatremia may be worsened by their low solute intake. The kidney's need to excrete solutes aids in water excretion. An increase in dietary protein and salt can help improve water excretion.

How do you reverse hyponatremia?

What conditions cause low sodium?

A low sodium level has many causes, including consumption of too many fluids, kidney failure, heart failure, cirrhosis, and use of diuretics. Symptoms result from brain dysfunction.

What drugs cause hypernatremia?

Can hypernatremia cause heart failure?

A patient presented with hypernatremia (plasma sodium level equals 171 mEq/L), marked congestive heart failure, and fluid retention. A high-salt intake and an inappropriate lack of thirst in this patient with poor cardiac function resulted in hypernatremia accompanied by edema.

What are the symptoms of high sodium levels in the blood?