Hypernatremia E87.0

Electrolyte disturbance in which the plasma Na+ concentration is > 150 mmol/l. Severe manifestations, in contrast to severe hyponatremia, have a higher morbidity and mortality, but are less frequent.

One possible cause is sodium retention or increased sodium intake. On the other hand, dehydration due to excessive sweating, burns or diabetes insipidus, for example, leads to fluid shifts from the intracellular to the extracellular space,

burns or due to diabetes insipidus, fluid shifts from the intra- to the extracellular space as well as an increase in plasma osmolarity.

Depending on the degree of severity, symptoms such as restlessness, but also lethargy, overexcitability, ataxia or cerebral seizures may occur.

Hypovolaemic hypernatraemia: volume substitution with 5% glucose solution +1/3 of the fluid deficit as isotonic solution.

Hypervolemic hypernatremia: possibly stop supply of hypertonic solutions. If serum sodium > 160nmol/l: 5% glucose solution +furosemide.

In case of renal failure: haemodialysis.