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Updated: Sep 2, 2025
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Published on: November 9, 2016
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Diagnostic and therapeutic approach to hypernatremia
1Department of Internal Medicine, Inmates ward, "Antonio Cardarelli" Hospital, Naples, Italy.
Diagnosis (Berlin, Germany)
|August 2, 2022
Summary
Hypernatremia, or high plasma sodium, can be acute or chronic and classified by volume status. Treatment focuses on restoring normal tonicity, with rapid correction for acute cases and slow correction for chronic hypernatremia.
Area of Science:
- Nephrology
- Endocrinology
- Internal Medicine
Background:
- Hypernatremia is defined as plasma sodium concentration > 145 mmol/L.
- It can be classified by duration (acute/chronic), severity (mild/moderate/severe), and volume status (hypervolemic/hypovolemic/euvolemic).
Purpose of the Study:
- To review the classification and pathogenesis of hypernatremia.
- To outline the treatment goals and strategies for managing hypernatremia.
Main Methods:
- This is a review of hypernatremia classification and management.
- Key etiological factors and treatment principles are discussed.
Main Results:
- Hypervolemic hypernatremia can result from increased sodium intake or primary hyperaldosteronism.
- Euvolemic hypernatremia is associated with diabetes insipidus (neurogenic or nephrogenic).
- Hypovolemic hypernatremia is caused by renal or extrarenal fluid losses.
Conclusions:
- The primary treatment goal is restoring plasma tonicity.
- Acute hypernatremia requires rapid correction to prevent cellular dehydration.
- Chronic hypernatremia necessitates slow correction (≤ 0.4 mmol/L/h) to avoid complications.
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