Hypernatremia

Hypernatremia is a condition characterized by an abnormally high concentration of sodium in the blood, typically above 145 mEq/L. It usually results from water loss exceeding sodium loss or, less commonly, excessive sodium intake. Common causes include dehydration due to inadequate fluid intake, excessive sweating, diarrhea, vomiting, or conditions like diabetes insipidus. Elderly individuals, infants, and critically ill patients are at higher risk because they may have impaired thirst mechanisms or limited access to water.

Clinically, hypernatremia presents with neurological symptoms due to cellular dehydration in the brain. Patients may experience thirst, confusion, irritability, muscle twitching, and, in severe cases, seizures or coma. The severity of symptoms often depends on how rapidly the sodium levels rise. Rapid onset hypernatremia is more dangerous compared to chronic cases, as the brain has less time to adapt.

Diagnosis is based on serum sodium levels and assessment of fluid balance. Treatment focuses on gradual correction of sodium levels using hypotonic fluids such as oral water or intravenous fluids. Rapid correction should be avoided to prevent cerebral edema. Preventive measures include adequate hydration and careful monitoring in high-risk individuals.