Hypernatraemia:

Definition:

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.

Symptoms:

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

Signs:

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

Investigations:

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.