Written by Dr.Md.Redwanul Huq (Masum)
Sunday, 15 January 2012 16:21



Hypernatremia is a clinical condition which is characterized by primary water depletion i.e. increased plasma osmolality.

Causes of Hypernatraemia:

1. Inadequate water retention (i.e. excessive water loss) by kidney:

i) Diabetes insipidus
ii) Diabetic ketoacidosis
iii) Hyperosmolar non- ketotic diabetic coma

2. Excessive Na+ retention :

i) Hyper-aldosteronism
ii) Cushing Syndrome

3. Excessive Na+ intake:

i) Diet
ii) Hypertonic sodium solution

4. Increased loss of water through lungs and skin:

i) Fever
ii) Hyperventilation
iii) Hot environment
iv) Hypothyroidism

5. Inadequate water intake.


1. Nausea
2. Vomiting
3. Irritability
4. Confusion


i) Spasticity
ii) Exaggerated reflexes
iii) Myoclonus
iv) Convulsion
v) Coma.


For hypernatremia following investigations are done-

1. Serum electrolytes
2. Investigations to find out the underlying cause.

Treatment of hypernatremia:

Treatment of hypernatremia can be as below-

1. If Na+ concentration is more than 170 mmol /L – 0.45 % NaCl is infused and if Na+ concentration is between 150 and 170 mmol /L – 0.45% NaCl or 5% dextrose is infused
2. Treatment of underlying cause.

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