A Clinical Approach to the Treatment of Chronic Hypernatremia

作者：Al Absi Ahmed; Gosmanova Elvira O; Wall Barry M^*

来源：American Journal of Kidney Diseases, 2012, 60(6): 1032-1038.

DOI：10.1053/j.ajkd.2012.06.025

• Hypernatremia
• osmolarity
• salt
• water loss

Hypernatremia is a commonly encountered electrolyte disorder occurring in both the inpatient and outpatient settings. Community-acquired hypernatremia typically occurs at the extremes of age, whereas hospital-acquired hypernatremia affects patients of all age groups. Serum sodium concentration is linked to water homeostasis, which is dependent on the thirst mechanism, arginine vasopressin, and kidney function. Because both hypernatremia and the rate of correction of hypernatremia are associated with significant morbidity and mortality, prompt effective treatment is crucial. Chronic hypernatremia can be classified into 3 broad categories, hypovolemic, euvolemic, and hypervolemic forms, with each form having unique treatment considerations. In this teaching case, we provide a clinically based quantitative approach to the treatment of both hypervolemic and hypovolemic hypernatremia, which occurred in the same patient during the course of a prolonged illness. Am J Kidney Dis. 60(6): 1032-1038. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc. This is a US Government Work. There are no restrictions on its use.

• 出版日期2012-12