Hypernatremia

Date: 17/03/22

Electrolyte Series: Hypernatraemia

• Not much to say about this one; not a large topic in itself (though some of the causes may be)
  
• Hypernatraemia is most commonly due to dehydration
  • Diarrhoea
  • Vomiting
  • Burns
    
• Other causes:
  • excessive saline administration
  • diabetes insipidus
  • Primary aldosteronism – especially if accompanied by hypertension, hypokalaemia and alkalosis
  • Uncontrolled hyperglycaemia
  • Ingestion of high salt load – seawater, salt in condiments/food (usually as part of a dare/other unwise behavior)
    
• Can present with:
  • Profound thirst
  • Confusion
  • Seizures
    
• Hartmann’s (CSL) is an excellent choice for fluids replacement
  
• Also encourage oral rehydration
  
• Aim to reduce serum sodium by 0.5-1mmol/L per hour and no more than 12 mmol/L/day. Correcting too quickly causes cerebral oedema.
  
• Check urine and serum osmolality to help rule in/out causes.