Hypernatremia

Hypernatremia is when there is too much salt (sodium) in the blood and not enough water. The cells of the brain become starved of water. This balance of water and salt in the body is vital to human function. Hypernatremia is rare and is often an emergency. It can happen to anyone, but it usually occurs in infants, the elderly, or the critically ill. In severe cases, hypernatremia can be life-threatening.

CAUSES

Hypernatremia may be the result of:

  • Not drinking enough water. Impaired thirst sensation usually contributes to this cause.

  • A condition where your kidneys remove too much urine from the body (polyuria). This is often related to diabetes.

  • Water loss through exercise or sweating.

  • Diarrhea or vomiting.

  • Excessive salt intake.

  • A genetic condition affecting the kidneys.

SYMPTOMS

  • Increased thirst (unless this sensation is impaired).

  • Increased urination.

  • Muscle twitching or cramps.

  • Dizziness or lightheadedness.

  • Seizures.

  • Headache.

  • Fatigue.

  • Generalized weakness.

  • Irritability.

  • Confusion.

  • Loss of consciousness.

  • Coma.

Symptoms of underlying illness that can lead to hypernatremia may also be present, such as:

  • Nausea.

  • Vomiting.

  • Diarrhea.

  • Fever.

  • Confusion (delirium).

  • Memory problems (dementia).

  • Diabetes.

  • A condition that affects the adrenal glands and results in too much cortisol (Cushing's syndrome).

DIAGNOSIS

Your caregiver will take your history and ask questions regarding water intake, potential water loss, urination, salt intake, medicines, and other symptoms. Your caregiver may also perform a physical or neurological exam. He or she may also order tests, such as blood and urine tests.

TREATMENT

Once diagnosed, hypernatremia needs to be treated right away. The goal is to balance the water and salt levels in the body. Treatment may be given through an intravenous line (IV) or given by mouth. Treatment often requires hospitalization for IV fluids and careful monitoring of lab tests. Treatment for hypernatremia will include intake of one or more of the following:

  • Water.

  • IV fluids.

Ongoing laboratory tests will be performed to help guide treatment options.

HOME CARE INSTRUCTIONS

  • Drink enough fluids to keep your urine clear or pale yellow.

  • Take all medicines as directed. Review all of your medicines with your caregiver regularly.

  • Avoid high-salt processed foods (canned, jarred, frozen, or boxed foods). Some examples include pickles, frozen dinners, canned soups, potato and corn chips, and olives.

  • Always replace fluids after exercise or after vomiting or diarrhea.

  • Manage underlying conditions that may cause hypernatremia. Ask your caregiver for additional support.

  • Follow up with your caregiver for ongoing monitoring as directed.

SEEK MEDICAL CARE IF:

You have questions or concerns.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.