The serum sodium concentration and thus serum osmolality areclosely controlled by water homeostasis, which is mediated bythirst, arginine vasopressin, and the kidneys.1 A disruptionin the water balance is manifested as an abnormality in theserum sodium concentration — hypernatremia or hyponatremia.2,3Hypernatremia, defined as a rise in the serum sodium concentrationto a value exceeding 145 mmol per liter, is a common electrolytedisorder. Because sodium is a functionally impermeable solute,it contributes to tonicity and induces the movement of wateracross cell membranes.4 Therefore, hypernatremia invariablydenotes hypertonic hyperosmolality and always causes cellulardehydration, at least . . . [Full Text of this Article]
Causes
Clinical Manifestations
Management
Pure Water Loss
Hypotonic Sodium Loss
Hypotonic Sodium and Potassium Loss
Hypertonic Sodium Gain
Common Errors in Management
Source Information
From the Department of Medicine, Baylor College of Medicine and Methodist Hospital, and the Renal Section, Department of Veterans Affairs Medical Center, Houston (H.J.A.); and the Department of Medicine, Tufts University School of Medicine, and the Division of Nephrology and Tupper Research Institute, New England Medical Center, Boston (N.E.M.).
Address reprint requests to Dr. Madias at the Division of Nephrology, New England Medical Center, Box 172, 750 Washington St., Boston, MA 02111, or at nmadias@infonet.tufts.edu.
References
Related Letters:
Hypernatremia
Halperin M. L., Cherney D. Z.I., Spital A., Adrogue H. J., Madias N. E.
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N Engl J Med 2000;
343:817-818, Sep 14, 2000.
Correspondence
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