333:
However, such high levels of sodium rarely occur without severe coexisting medical conditions. Serum sodium concentrations have ranged from 150 to 228 mmol/L in survivors of acute salt overdosage, while levels of 153–255 mmol/L have been observed in fatalities. Vitreous humor is considered to be a better postmortem specimen than postmortem serum for assessing sodium involvement in a death.
51:
332:
Severe symptoms are usually due to acute elevation of the plasma sodium concentration to above 157 mmol/L (normal blood levels are generally about 135–145 mmol/L for adults and elderly). Values above 180 mmol/L are associated with a high mortality rate, particularly in adults.
421:
fluid (a fluid with a higher concentration of solutes than the remainder of the body) with restricted free water intake. This is relatively uncommon, though it can occur after a vigorous resuscitation where a patient receives a large volume of a concentrated
353:
Inadequate intake of free water associated with total body sodium depletion. Typically in elderly or otherwise disabled patients who are unable to take in water as their thirst dictates and also are sodium depleted. This is the most common cause of
1355:
1340:
492:) adapts to the higher sodium concentration. Rapidly lowering the sodium concentration with free water, once this adaptation has occurred, causes water to flow into brain cells and causes them to swell. This can lead to
487:
in the bloodstream), but rather can be given intravenously in solution with dextrose (sugar) or saline (salt). However, overly rapid correction of hypernatremia is potentially very dangerous. The body (in particular the
869:
375:
results in hypotonic (dilute) watery diarrhea resulting in significant loss of free water and a higher concentration of sodium in the blood; this type of water loss can also be seen with
1197:
Paut, O.; André, N.; Fabre, P.; Sobraquès, P.; Drouet, G.; Arditti, J.; Camboulives, J. (1999). "The management of extreme hypernatraemia secondary to salt poisoning in an infant".
430:
also causes hypernatremia because seawater is hypertonic and free water is not available. There are several recorded cases of forced ingestion of concentrated salt solution in
1455:
976:"Fatal voluntary salt intake resulting in the highest ever documented sodium plasma level in adults (255 mmol L) a disorder linked to female gender and psychiatric disorders"
196:). Hypernatremia is generally defined as a serum sodium level of more than 145 mmol/L. Severe symptoms typically only occur when levels are above 160 mmol/L.
321:
The major symptom is thirst. The most important signs result from brain cell shrinkage and include confusion, muscle twitching or spasms. With severe elevations,
1647:
1448:
855:
450:
is the most common cause in children. It has also been seen in a number of adults with mental health problems. Too much salt can also occur from
1241:
Carlberg, D. J.; Borek, H. A.; Syverud, S. A.; Holstege, C. P. (2013). "Survival of Acute
Hypernatremia Due to Massive Soy Sauce Ingestion".
860:
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894:
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1041:
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The cornerstone of treatment is administration of free water to correct the relative water deficit. Water can be replaced orally or
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1510:
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1661:
1126:
Leroy, C.; Karrouz, W.; Douillard, C.; Do Cao, C.; Cortet, C.; Wémeau, J. L.; Vantyghem, M. C. (2013). "Diabetes insipidus".
298:
263:
can result in a falsely high sodium measurement. The cause can usually be determined by the history of events. Testing the
1059:
865:
313:, and the elderly. Hypernatremia is associated with an increased risk of death, but it is unclear if it is the cause.
290:
1515:
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94:
1703:
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132:
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107:
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If the onset of hypernatremia was over a few hours, then it can be corrected relatively quickly using
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483:. Water alone cannot be administered intravenously (because of osmolarity issues leading to
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232:
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can help if the cause is unclear. The underlying mechanism typically involves too little
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corrected. Hypernatremia affects 0.3–1% of people in hospital. It most often occurs in
220:
99:
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1493:
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993:
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185:
165:
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Saunders, N.; Balfe, J. W.; Laski, B. (1976). "Severe salt poisoning in an infant".
1087:
1057:
Coe, J. I. (1993). "Postmortem chemistry update. Emphasis on forensic application".
1010:
729:
Kliegman, Robert M.; Stanton, Bonita M. D.; Geme, Joseph St; Schor, Nina F. (2015).
1698:
1637:
1255:
1227:
890:
Department of Health & Human
Services, State Government of Victoria, Australia
533:
497:
294:
285:. Otherwise, correction should occur slowly with, for those unable to drink water,
282:
204:
500:, or death. Therefore, significant hypernatremia should be treated carefully by a
1375:
1656:
1291:
1163:
971:
691:
Muhsin, SA; Mount, DB (March 2016). "Diagnosis and treatment of hypernatremia".
480:
275:
200:
1139:
1105:(10th ed.). Seal Beach, Ca.: Biomedical Publications. pp. 1855–1856.
787:
Ranasinghe, Sudharma; Wahl, Kerri M.; Harris, Eric; Lubarsky, David J. (2012).
704:
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usually does not lead to hypernatremia unless free water intake is restricted.
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blood test demonstrates a sodium concentration higher than 145 mmol/L.
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the medication causing the problem may need to be stopped or the underlying
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Excessive losses of water from the urinary tract – which may be caused by
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103:
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651:
Lin, M; Liu, SJ; Lim, IT (August 2005). "Disorders of water imbalance".
322:
240:
199:
Hypernatremia is typically classified by a person's fluid status into
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1344:
306:
189:
169:
161:
83:
58:
693:
Best
Practice & Research Clinical Endocrinology & Metabolism
489:
264:
224:
814:
Khanna, A (May 2006). "Acquired
Nephrogenic Diabetes Insipidus".
326:
256:
1437:
920:
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or other medical professional with experience in treatment of
243:
among other causes. High volume hypernatremia can be due to
365:) – leads to a combination of sodium and free water losses.
392:
Excessive excretion of water from the kidneys caused by
1277:
Adrogué, H. J.; Madias, N. E. (2000). "Hypernatremia".
589:
Reynolds, RM; Padfield, PL; Seckl, JR (25 March 2006).
735:(20 ed.). Elsevier Health Sciences. p. 348.
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914:
Reynolds, R.; Padfield, P. L.; Seckl, J. R. (2006).
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35:
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404:, or impaired responsiveness of the kidneys to it.
291:diabetes insipidus as a result of a brain disorder
168:. Early symptoms may include a strong feeling of
790:Anesthesiology Board Review Pearls of Wisdom 3/E
1103:Disposition of Toxic Drugs and Chemicals in Man
496:, potentially resulting in seizures, permanent
970:Ofran, Y.; Lavi, D.; Opher, D.; Weiss, T. A.;
396:, which involves either inadequate release of
368:Water losses associated with extreme sweating.
1449:
849:
847:
845:
8:
299:diabetes insipidus is due to kidney problems
223:. Normal volume hypernatremia can be due to
766:. Jaypee Brothers Publishers. p. 329.
653:Emergency Medicine Clinics of North America
413:In those with high volume or hypervolemia:
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1323:
584:
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388:In those with normal volume or euvolemia:
247:, excessive administration of intravenous
207:. Low volume hypernatremia can occur from
49:
32:
1024:Shier, D.; Butler, J.; Lewis, R. (2006).
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349:In those with low volume or hypovolemia:
341:Common causes of hypernatremia include:
793:. McGraw Hill Professional. p. 6.
550:
440:excess due to a disease state such as
117:Low volume, normal volume, high volume
27:High sodium concentration in the blood
872:from the original on 27 December 2015
861:Merck Manual of Diagnosis and Therapy
293:, may be treated with the medication
7:
1551:Familial hypocalciuric hypercalcemia
361:, or other osmotic diuretics (e.g.,
1667:Hypokalemic sensory overstimulation
1028:Hole's Human Anatomy and Physiology
763:Essentials of Critical Care Nursing
1212:10.1046/j.1460-9592.1999.9220325.x
467:Hypernatremia is diagnosed when a
25:
524:in nephropathy also can be used.
255:, or rarely from eating too much
1072:10.1097/00000433-199306000-00001
994:10.1111/j.1365-2796.2004.01411.x
828:10.1016/j.semnephrol.2006.03.004
749:from the original on 2017-09-08.
1643:Hyperkalemic periodic paralysis
1511:Disorders of calcium metabolism
188:sodium levels are 135–145
182:bleeding in or around the brain
108:bleeding in or around the brain
1714:Cerebral salt-wasting syndrome
1662:Hypokalemic periodic paralysis
1256:10.1016/j.jemermed.2012.11.109
508:. Specific treatments such as
1:
1176:10.1016/s0022-3476(76)80992-4
916:"Disorders of sodium balance"
732:Nelson Textbook of Pediatrics
591:"Disorders of sodium balance"
160:, is a high concentration of
1060:Am. J. Forensic Med. Pathol.
485:rupturing of red blood cells
127:Serum sodium > 145 mmol/L
1516:Hypercalcemia of malignancy
1292:10.1056/NEJM200005183422006
892:Better Health Channel: Salt
866:Medical Library Association
854:Lewis, J. L. (March 2013).
595:BMJ (Clinical Research Ed.)
1758:
1140:10.1016/j.ando.2013.10.002
705:10.1016/j.beem.2016.02.014
176:. Severe symptoms include
665:10.1016/j.emc.2005.03.001
434:rituals leading to death.
57:
48:
1737:Electrolyte disturbances
1545:Dystrophic calcification
1541:Metastatic calcification
934:10.1136/bmj.332.7543.702
760:Kuruvilla, Jaya (2007).
607:10.1136/bmj.332.7543.702
518:congestive heart failure
371:Severe watery diarrhea (
261:Low blood protein levels
180:, muscle twitching, and
172:, weakness, nausea, and
138:Low blood protein levels
1134:(5–6). Paris: 496–507.
303:electrolyte disturbance
289:. Hypernatremia due to
1465:Electrolyte imbalances
1101:Baselt, R. C. (2014).
901:Last updated: May 2014
816:Seminars in Nephrology
309:, those with impaired
133:Differential diagnosis
1034:McGraw-Hill Companies
506:electrolyte imbalance
469:basic metabolic panel
377:viral gastroenteritis
233:increased breath rate
203:, normal volume, and
1506:Milk-alkali syndrome
426:solution. Ingesting
398:antidiuretic hormone
283:5% dextrose in water
106:, muscle twitching,
86:, weakness, nausea,
1490:Symptoms and signs
1319:at Lab Tests Online
217:diuretic medication
1397:External resources
1200:Paediatr. Anaesth.
897:2016-04-02 at the
510:thiazide diuretics
424:sodium bicarbonate
394:diabetes insipidus
317:Signs and symptoms
287:half-normal saline
253:sodium bicarbonate
245:hyperaldosteronism
237:diabetes insipidus
1724:
1723:
1431:
1430:
1286:(20): 1493–1499.
1032:(11th ed.).
928:(7543): 702–705.
659:(3): 749–70, ix.
452:drinking seawater
151:
150:
147:~0.5% in hospital
123:Diagnostic method
71:Hospital medicine
30:Medical condition
16:(Redirected from
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1531:Calcinosis cutis
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1280:N. Engl. J. Med.
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438:Mineralcorticoid
373:osmotic diarrhea
174:loss of appetite
88:loss of appetite
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981:J. Intern. Med.
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899:Wayback Machine
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856:"Hypernatremia"
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601:(7543): 702–5.
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522:corticosteroids
477:
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442:Conn's syndrome
411:
402:pituitary gland
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156:, also spelled
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1692:Salt poisoning
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1311:External links
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1250:(2): 228–231.
1244:J. Emerg. Med.
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987:(6): 525–528.
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699:(2): 189–203.
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539:Salt poisoning
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514:chlorthalidone
494:cerebral edema
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448:Salt poisoning
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229:extreme thirst
221:kidney disease
158:hypernatraemia
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100:Cardiac arrest
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18:Salt retention
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1527:Calciphylaxis
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1494:Chvostek sign
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1422:Hypernatremia
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1170:(2): 258–61.
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532:
531:
527:
525:
523:
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511:
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491:
486:
482:
481:intravenously
474:
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457:
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436:
433:
429:
425:
420:
416:
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399:
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389:
384:Normal volume
383:
378:
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370:
367:
364:
360:
356:
352:
351:
350:
344:
342:
336:
334:
330:
328:
324:
316:
314:
312:
311:mental status
308:
304:
300:
296:
292:
288:
284:
280:
279:normal saline
277:
272:
271:in the body.
270:
266:
262:
258:
254:
250:
249:normal saline
246:
242:
238:
234:
230:
226:
222:
218:
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210:
206:
202:
197:
195:
191:
187:
183:
179:
175:
171:
167:
163:
159:
155:
154:Hypernatremia
146:
142:
139:
136:
134:
130:
126:
124:
120:
116:
112:
109:
105:
101:
98:
96:
95:Complications
92:
89:
85:
81:
79:
75:
72:
69:
67:
63:
60:
56:
52:
47:
43:
39:
36:Hypernatremia
34:
19:
1686:
1415:
1404:
1380:
1369:
1354:
1339:
1283:
1278:
1272:
1247:
1242:
1236:
1203:
1198:
1192:
1167:
1162:
1156:
1131:
1127:
1121:
1102:
1096:
1063:
1058:
1052:
1027:
1019:
984:
979:
925:
919:
886:
874:. Retrieved
859:
822:(3): 244–8.
819:
815:
809:
789:
782:
762:
755:
731:
696:
692:
656:
652:
598:
594:
534:Hyponatremia
498:brain damage
478:
466:
417:Intake of a
412:
387:
348:
340:
331:
320:
295:desmopressin
273:
231:, prolonged
211:, vomiting,
198:
157:
153:
152:
1164:J. Pediatr.
876:25 December
409:High volume
329:may occur.
276:intravenous
239:, and from
205:high volume
82:Feeling of
41:Other names
1731:Categories
1523:Calcinosis
1417:Patient UK
1382:DiseasesDB
972:Elinav, E.
818:(Review).
545:References
419:hypertonic
359:glycosuria
345:Low volume
269:free water
201:low volume
1704:Hypotonic
1630:Potassium
1607:Phosphate
1584:Magnesium
1411:emerg/263
1406:eMedicine
502:physician
475:Treatment
463:Diagnosis
456:soy sauce
400:from the
297:. If the
192:(135–145
184:. Normal
178:confusion
144:Frequency
104:confusion
66:Specialty
1709:Isotonic
1561:Chloride
1300:10816188
1264:23735849
1220:10189662
1148:24286605
1088:35536508
1011:20446209
1003:15554954
974:(2004).
952:16565125
895:Archived
870:Archived
836:16713497
747:Archived
713:27156758
673:15982544
625:16565125
528:See also
432:exorcism
428:seawater
363:mannitol
323:seizures
213:diarrhea
209:sweating
78:Symptoms
1473:Calcium
1376:D006955
1228:3212802
1184:1249688
1080:8328447
943:1410848
616:1410848
512:(e.g.,
241:lithium
164:in the
1742:Sodium
1679:Sodium
1648:equine
1317:Sodium
1298:
1262:
1226:
1218:
1182:
1146:
1109:
1086:
1078:
1040:
1009:
1001:
950:
940:
834:
797:
770:
739:
711:
671:
623:
613:
307:babies
190:mmol/L
170:thirst
162:sodium
84:thirst
59:Sodium
1365:276.0
1350:E87.0
1224:S2CID
1084:S2CID
1007:S2CID
516:) in
490:brain
337:Cause
327:comas
265:urine
225:fever
219:, or
194:mEq/L
186:serum
166:blood
114:Types
1687:High
1638:High
1615:High
1592:High
1569:High
1481:High
1387:6266
1371:MeSH
1360:9-CM
1296:PMID
1260:PMID
1216:PMID
1180:PMID
1144:PMID
1107:ISBN
1076:PMID
1038:ISBN
999:PMID
948:PMID
878:2015
832:PMID
795:ISBN
768:ISBN
737:ISBN
709:PMID
669:PMID
621:PMID
325:and
281:and
257:salt
1699:Low
1657:Low
1620:Low
1597:Low
1574:Low
1486:Low
1356:ICD
1341:ICD
1288:doi
1284:342
1252:doi
1208:doi
1172:doi
1136:doi
1068:doi
989:doi
985:256
938:PMC
930:doi
926:332
921:BMJ
824:doi
701:doi
661:doi
611:PMC
603:doi
599:332
520:or
454:or
251:or
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991::
954:.
932::
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838:.
826::
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776:.
715:.
703::
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663::
627:.
605::
458:.
20:)
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