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Hypernatremia

  • Kenneth B. ChristopherEmail author
Chapter
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Abstract

Hypernatremia is common in the critically ill. Etiology is most often related to high free water losses and or inadequate free water repletion. Diagnosis can be made with serum sodium and evaluation of patient story, course, and medication history. Free water repletion amounts are determined by using formulas to calculate free water deficit and ongoing free water loss. The most important management issue is to ensure adequate free water replacement during ongoing free water losses in the setting of a free water deficit.

Keywords

Hypernatremia Sodium Free water Repletion 

References

  1. 1.
    Lindner G, Funk GC, Schwarz C, et al. Hypernatremia in the critically ill is an independent risk factor for mortality. Am J Kidney Dis. 2007;50(6):952–7.CrossRefGoogle Scholar
  2. 2.
    Funk GC, Lindner G, Druml W, et al. Incidence and prognosis of dysnatremias present on ICU admission. Intensive Care Med. 2010;36(2):304–11.CrossRefGoogle Scholar
  3. 3.
    Lindner G, Kneidinger N, Holzinger U, Druml W, Schwarz C. Tonicity balance in patients with hypernatremia acquired in the intensive care unit. Am J Kidney Dis. 2009;54(4):674–9.CrossRefGoogle Scholar
  4. 4.
    Namdar T, Stollwerck PL, Stang FH, et al. Progressive fluid removal can avoid electrolyte disorders in severely burned patients. Ger Med Sci. 2011;9:Doc13.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Mamtani A, Odom SR, Butler KL. Diabetes insipidus uncovered during conservative management of complicated acute appendicitis. Clin Case Rep. 2016;4(5):491–3.CrossRefGoogle Scholar
  6. 6.
    Blum D, Brasseur D, Kahn A, Brachet E. Safe oral rehydration of hypertonic dehydration. J Pediatr Gastroenterol Nutr. 1986;5(2):232–5.CrossRefGoogle Scholar
  7. 7.
    Kahn A, Brachet E, Blum D. Controlled fall in natremia and risk of seizures in hypertonic dehydration. Intensive Care Med. 1979;5(1):27–31.CrossRefGoogle Scholar
  8. 8.
    Sterns RH. Evidence for managing hypernatremia. is it just hyponatremia in reverse? Clin J Am Soc Nephrol. 2019;14(5):645–7.CrossRefGoogle Scholar
  9. 9.
    Shah MK, Mandayam S, Adrogue HJ. Osmotic demyelination unrelated to hyponatremia. Am J Kidney Dis. 2018;71(3):436–40.CrossRefGoogle Scholar
  10. 10.
    Ostermann M, Dickie H, Tovey L, Treacher D. Management of sodium disorders during continuous haemofiltration. Crit Care. 2010;14(3):418.CrossRefGoogle Scholar
  11. 11.
    Park HS, Hong YA, Kim HG, et al. Usefulness of continuous renal replacement therapy for correcting hypernatremia in a patient with severe congestive heart failure. Hemodial Int. 2012;16(4):559–63.CrossRefGoogle Scholar
  12. 12.
    Paquette F, Goupil R, Madore F, Troyanov S, Bouchard J. Continuous venovenous hemofiltration using customized replacement fluid for acute kidney injury with severe hypernatremia. Clin Kidney J. 2016;9(4):540–2.CrossRefGoogle Scholar
  13. 13.
    Fulop T, Zsom L, Rodriguez RD, Chabrier-Rosello JO, Hamrahian M, Koch CA. Therapeutic hypernatremia management during continuous renal replacement therapy with elevated intracranial pressures and respiratory failure. Rev Endocr Metab Disord. 2019;20(1):65–75.CrossRefGoogle Scholar
  14. 14.
    Pokaharel M, Block CA. Dysnatremia in the ICU. Curr Opin Crit Care. 2011;17(6):581–93.CrossRefGoogle Scholar
  15. 15.
    Polderman KH, Schreuder WO, Strack van Schijndel RJ, Thijs LG. Hypernatremia in the intensive care unit: an indicator of quality of care? Crit Care Med. 1999;27(6):1105–8.CrossRefGoogle Scholar
  16. 16.
    Darmon M, Timsit JF, Francais A, et al. Association between hypernatraemia acquired in the ICU and mortality: a cohort study. Nephrol Dial Transplant. 2010;25(8):2510–5.CrossRefGoogle Scholar
  17. 17.
    Sam R, Hart P, Haghighat R, Ing TS. Hypervolemic hypernatremia in patients recovering from acute kidney injury in the intensive care unit. Clin Exp Nephrol. 2012;16(1):136–46.CrossRefGoogle Scholar
  18. 18.
    Truche AS, Ragey SP, Souweine B, et al. ICU survival and need of renal replacement therapy with respect to AKI duration in critically ill patients. Ann Intensive Care. 2018;8(1):127.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of Renal MedicineBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA

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