What is it?
Hypernatremia is a greater than normal concentration of sodium in the blood. Sodium is an electrolyte that helps with nerve and muscle function, and also helps to maintain blood pressure. May also be spelled hypernatraemia.
Who gets it?
Hypernatremia is most common in the elderly, who may not recognize that they are thirsty or are unable to get themselves something to drink. It is also more likely to occur in people who take diuretics, which cause the kidneys to excrete (rid the body of) more water, and in those with diabetes insipidus or diseases of the hypothalamus or pituitary gland, which can also interfere with normal kidney function.
What causes it?
Sodium must be maintained at a specific concentration in the blood and the fluid surrounding the body’s cells for the body to function properly. The body maintains a balance of sodium in the blood by matching the amount of sodium ingested with the amount excreted (put out) by the kidneys. Hypernatremia occurs when the body loses too much water in relation to the amount of sodium in the blood. Excessive water loss can occur if the kidneys excrete too much urine (called polyuria). Or, it can be caused by excessive sweating during intense heat or exercise, prolonged diarrhea or vomiting, or simply by not drinking enough water. Hypernatremia can also be caused by a high salt intake, either in the diet or in intravenous treatments for other conditions.
What are the symptoms?
Symptoms of hypernatremia depend upon the cause. When water is lost through diarrhea or vomiting, for example, the patient urinates very little, with the small amounts of urine produced having a dark yellow color. If hypernatremia is caused by kidney dysfunction, the patient urinates large quantities of clear urine, much like water. When the sodium concentration in the blood is extremely high, it affects the brain cells. As this occurs, the patient experiences muscle twitching, and begins to feel tired and confused. Eventually, severe hypernatremia can lead to coma and death, especially in young children and the elderly.
How is it diagnosed?
Hypernatremia is diagnosed by measuring the sodium levels in a blood sample. Normal blood sodium levels are 136 to 145 milliequivalents per liter (mEq/L) of blood. A patient with hypernatremia will have a blood sodium level higher than 145 mEq/L. Physicians will also look for any underlying causes of hypernatremia, such as diabetes insipidus or other disorders.
What is the treatment?
Hypernatremia is treated by replacing the lost fluids. In mild cases, this can be done by drinking electrolyte replacement fluids. In more severe cases, fluids are given intravenously (through a vein). The fluid is given slowly, and the blood sodium levels are constantly monitored so the sodium/water levels are brought to the proper balance. Unless brain function has been affected, most people make a full recovery from hyernatremia.
Self-care tips
You can prevent hypernatremia by drinking plenty of fluids, especially during extremely hot weather and intense exercise. If you are sick and symptoms include vomiting or diarrhea, follow your doctor’s recommendations for replacing lost fluids with clear liquids or electrolyte replacement fluids. If you have a medical condition that affects kidney function, make sure you follow your doctor’s treatment guidelines.
This information has been designed as a comprehensive and quick reference guide written by our health care reviewers. The health information written by our authors is intended to be a supplement to the care provided by your physician. It is not intended nor implied to be a substitute for professional medical advice.
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