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Hypernatremia

Overview

Hypernatremia is the medical term for having too much sodium in the blood. Sodium is an essential nutrient for the body's proper functioning. The blood contains the majority of the sodium in the body. It is also present in the body's lymph fluids and cells.

 

Hypernatremia is often mild and does not create serious problems. However, correcting elevated sodium levels is important for preventing or reversing hypernatremia-related complications.

Causes

Hypernatremia develops when the body gains too much sodium or loses too much water. As a result, body water is insufficient in comparison to total body sodium. Changes in water intake or loss might impact the sodium concentration in the blood. Changes in the fluid can be caused by various factors, including significant changes in thirst and changes in the concentration of urine. In healthy humans, thirst and urine concentrations are triggered by brain receptors that detect the need for fluid or sodium adjustment. This usually results in higher water intake or changes in sodium excretion in the urine. As a result, hypernatremia can be quickly corrected.

Hypernatremia is more common in older adults. That's because as you become older, your feeling of thirst tends to decrease. You may also be more prone to conditions that disrupt the balance of water and sodium in your body.

Certain medical conditions may also cause hypernatremia, such as:

  • Severe watery diarrhea
  • Fever
  • Vomiting
  • Dehydration
  • Dementia or delirium
  • Poorly managed diabetes 
  • Large burn areas on the skin
  • Some medications
  • Kidney disease 
  • Diabetes insipidus 

Signs and Symptoms

The following are some of the symptoms of hypernatremia:

  • Extreme thirst
  • Restlessness and irritability
  • Lethargy and muscle weakness
  • Confusion
  • Seizures
  • Loss of consciousness

Diagnosis

Blood tests are commonly used to diagnose hypernatremia. Urine tests can also be used to detect elevated sodium levels as well as urine concentration. Both blood and urine testing are quick, non-invasive procedures that don't require any preparation.

 

In most cases, hypernatremia develops as a result of underlying conditions. Other tests may also be ordered based on your medical history and any additional symptoms you may be experiencing.

Treatment

Hypernatremia can develop quickly (within 24 hours) or gradually over time (more than 24 to 48 hours). Your doctor will be able to select a treatment plan based on the time it takes for symptoms to appear. Every treatment aims to restore your body's fluid and sodium balance. Hypernatremia that develops quickly will be treated more aggressively than hypernatremia that develops slowly.

 

You may be able to treat the condition by increasing your fluid intake in mild cases. In more serious cases, you'll almost certainly be connected to an IV drip. This is used to administer fluids to your blood intravenously. Your doctor will also monitor you to see if your sodium levels are improving, and if so, your fluid concentration may need to be adjusted.

Complications

The most common symptom of hypernatremia is thirst. The most severe symptoms of hypernatremia are caused by brain dysfunction and can cause confusion, twitching of muscles, seizures, coma, and death.

Prognosis

The prognosis for hypernatremia is generally good. This is especially true if the condition is detected early or underlying issues are addressed.  In most cases, hypernatremia can be treated without going to the hospital. Close monitoring helps ensure a healthy outcome if hospitalization is required.

Prevention

The simplest way to avoid hypernatremia is to stay hydrated and consume a healthy amount (1500 mg per day) of sodium. An average adult should drink four to eight cups of water per day. To avoid dehydration and hypernatremia, drink more if you take certain medications, are very active, live in a hot climate, or are at a high altitude.

Most people can avoid hypernatremia by eating a healthy, balanced diet and staying hydrated. On the other hand, hypernatremia can be caused by an electrolyte imbalance caused by another underlying condition. In this case, it is a medical emergency and should be managed by doctors. 

 

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on April 28th, 2023.