Understanding Hypernatremia: Causes, Symptoms, Diagnosis, and Treatment Approaches for Elevated Sodium Levels in Blood

Definition of Hypernatremia

Hypernatremia is a condition where sodium levels in the blood exceed 145 mEq/L, usually due to water loss, excess sodium intake, or an underlying medical disorder affecting the water balance.

Causes:

1. Water Loss: 

Dehydration from vomiting, diarrhea, excessive sweating, or burns. Diabetes insipidus leads to excessive urination and water loss.

2. Excess Sodium Intake: 

High sodium diets, hypertonic IV fluids, or sodium bicarbonate administration.

3. Reduced Water Intake:

Elderly, infants, or unconscious patients may be unable to drink water. Neurological disorders can impair thirst perception.

Additional Cause of Hypernatremia :

4. Hormonal Imbalances: Cushing’s syndrome (excess cortisol) and hyperaldosteronism (excess aldosterone) increase sodium retention.

Symptoms:

Thirst, confusion, irritability

Muscle twitching, weakness

Seizures, coma (severe cases)

Dizziness.

Diagnosis:

Blood tests: 

Confirm high sodium levels (>145 mEq/L).

Urine osmolality:

Helps determine if the cause is water loss or sodium retention.

Serum osmolality: 

Assesses overall fluid balance and hypertonicity.

Treatment:

Mild cases: Oral rehydration with water.

Severe cases: IV fluids (hypotonic solutions like 0.45% saline or D5W) given slowly to prevent cerebral edema.

Addressing underlying causes (e.g., diabetes insipidus, dehydration).

Monitoring sodium levels closely to ensure gradual correction and prevent complications.

Hypernatremia requires timely management to prevent severe complications.

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