Hypernatraemia
Hypernatraemia
Causes:
· Major burns
· Polyuric phase of ARF
· Carbenoxalone
o Causes pseudo hyperaldosteronism: Hypertension, hypokalaemia, hypernatraemia
Serum Na >145 mmol/L
Occurs when water intake is reduced or where water loss is increased (eg. Watery diarrhoea)
Usually picked up incidentally.
Check hyperglycaemia and hypercalcaemia
Check urine and plasma osmolality
– Urine osm < plasma osm = consider diabetes insipidus
– Urine osm > plasma osm = consider osmotic diuresis/ heatstroke
If patient is also hypovolaemic, then monitor UO and renal function
Treatment:
Treat underlying cause
IN mild cases, replace missing body water with water or glucose 5% iv
IN severe cases, (eg >170) – give iv 5% glucose if normovolameic or 5% saline if hypovolaemic