Hypernatremia

Hypernatremia is a very disturbing condition that leads to the development of very discomforting symptoms. In the absence of treatment, it may even result in death. Read on to know all about the causes, symptoms, diagnosis and treatment of Hypernatremia.

Hypernatremia Definition

Medical researchers define Hypernatremia as a condition marked by a high concentration of serum sodium above 145 mM. In healthy people, normal concentration of sodium is 136-145 mM in the blood plasma.

In the United States, Hyponatremia is the most prevalent electrolyte disease.

Hypernatremia Names

Some of the alternative names for this disease are

• Euvolemic hyponatremia
• Dilutional hyponatremia
• Hypovolemic hyponatremia
• Hypervolemic hyponatremia

Hypernatremia Symptoms

Some of the most common symptoms of Hypernatremia are

• Fatigue
• Convulsions
• Irritability
• Headache
• Cramps or muscular spasms
• Nausea
• Dehydration
• Muscular weakness
• Vomiting
• Restlessness
• Loss of appetite

A person with this disorder also commonly suffer from other serious effects of Hypernatremia such as abnormalities in mental state, that includes

• Hallucinations
• Confusion
• Reduced consciousness

There is also the possibility that some suffering individuals may enter into a coma.

Hypernatremia Causes

Some of the main causes of Hypernatremia are

• Sweating
• Vomiting
• Burns
• Syndrome of inappropriate antidiuretic hormone secretion (also referred to as SIADH)
• Congestive heart failure
• Diuretic medications, which increase urine output
• Diarrhea
• Liver cirrhosis
• Kidney diseases

Sodium can mostly be found in the body fluids external to the cells, which helps in maintaining blood pressure. Sodium is also necessary for proper functioning of the muscles and nerves in the human body.

In some cases, there is a drop in the amount of sodium in the fluids external to cells. In such cases, water shifts inside the cells to maintain balance of the levels. A high amount of water leads to the inflammation of cells. Most cells can adjust with this inflammation. However, the brain cells find it unable to handle swelling, as they are contained within the skull bones. Most signs of Hypernatremia are a result of brain inflammation.

The imbalance of salt-water in Hyponatremia is a result of any of these three conditions:

Euvolemic Hyponatremia

There is an increase in the total amount of water in the body. However, the amount of sodium remains unchanged in the human body.

Hypervolemic Hyponatremia

In this condition, there is an increase in the amount of both water and sodium in the human body. However, the gain in water content is greater than the increase in sodium levels.

Hypovolemic Hyponatremia

This disorder is characterized by the loss of both sodium and water from the body. However, the loss of sodium is more than that of water.

Hyponatremia Diagnosis

The diagnosis of this condition involves a complete physical examination that helps doctors determine the cause of the discomforting symptoms. Many patients have to undergo urine and blood tests. Hyponatremia can be confirmed by laboratory tests like:

• Urine sodium test
• Urine osmolality test
• Osmolality blood test
• Comprehensive metabolic panel (which involves blood sodium)

Hypernatremia Treatment

It is necessary to diagnose and cure the cause of Hyponatremia. This is because this disorder may be caused by cancerous conditions in some cases. Sodium imbalance can be treated with the aid of curative methods like:

• Radiation
• Chemotherapy
• Surgery (for tumor removal)

Other treatments for Hyponatremia may include administering of fluids through a vein, restricting intake of water and using medications to provide relief from symptoms.

Hypernatremia Complications

Patients begin experiencing severe Hypernatremia symptoms when the level of sodium crosses 158 meq/L (meilliEquivalents/liter). In the early stage of increase in sodium level, patients suffer from discomforting symptoms such as

• Occasional chorea
• General twitching
• Involuntary jerky movements of the shoulders, hips and face

Many patients also suffer from a condition known as Hyperreflexia (characterized by hyperactivity of reflexes). At this stage, seizures may also occur. In advanced phase of Hypernatremia, the patient can enter into a coma. The condition can turn fatal if the level of sodium in the bloodstream becomes more than 180 Meg per liter. However, it is only in rare cases that sodium levels reach a level this high.

In worst cases, this condition may lead to extreme complications like hernia of brain, possible coma and even death.

Hypernatremia Correction

Administration of free water forms the basis of Hypernatremia cure. It aims to correct the relative deficit water in the body that the disease gives rise to. The substitution of water can be done in an intravenous or oral manner. However, intravenous administration of water is not enough to cure the disorder due to the issue of Osmolarity. Instead, this can be given in addition to saline or dextrose infusion solutions.

It must be remembered that very quick correction of Hypernatremia can be highly dangerous. The human body, especially the brain, adapts to a higher sodium concentration. Once this adaptation takes place, rapid reduction of the sodium concentration along with free water can lead to the flow of water into brain cells and lead to cellular inflammation. This can result in complications like

• Potential seizures
• Cerebral edema
• Permanent brain damage
• Death

Consequently, acute Hypernatremia should be carefully cured by a medical professional or a physician experienced in curing imbalance of electrolytes. Rapidly correcting Hypernatremia can lead to death in worst cases.

Hypernatremia Calculator

If you have a family member suffering from this condition you may use this online hypernatremia correction calculator to measure the water deficit. This can be a helpful guide. However, you are not advised to use this for accurate medical treatment of the patient.

Hypernatremia and Diabetes Insipidus

This condition may also arise in individuals suffering from Diabetes Insipidus who suffer from excessive excretion of water from their kidneys. If such patients have access to water and do not suffer from great thirst, they may manage the Hypernatremia symptoms well and not suffer from any progression of the syndrome. However, this condition can also result in brain dysfunction in sufferers.

Hypernatremia Management

The management of Hypernatremia of can be done by

• Administration of diuretics
• Discontinuation of hypertonic sodium administration

If you indulge in any sports activities, drink fluids that consist of electrolytes. Sports drinks are rich in electrolytes and ideal for drinking. Intake of only water during high-energy sports events can give rise to cases of Acute Hyponatremia.

Hypernatremia Pathophysiology

This condition is marked by a free, water deficient state where the total deficit of water is greater than the total sodium deficit in the body. There is either excessive loss of water or high retention of sodium. A patient lacks usual physiologic response to free loss of water in this disorder.

Neonatal Hypernatremia

This condition arises in neonates (babies aged within four weeks). It is typically caused by inadequate or reduced feeding of breast milk. It is a potentially dangerous condition in very young children. Acute mortality and morbidity in breastfed infants can be avoided by regular follow-ups by professional health-care providers. The weight of infants should also be monitored until the commencement of growth to reduce the likelihood of this disorder in firstborns.

Chronic Hypernatremia

This condition, especially in young people, is typically a result of changes in the mechanisms that control balance of fluids. It may be caused by problems like

• Excessive water loss, as in sufferers of Diabetes Insipidus
• Inadequate fluid intake, as in patients of Adipsic Hypernatremia

Adipsic Hypernatremia

It is a rare disease that results from a combination of Adipsia and partial central Diabetes Insipidus. It is generally secondary to a Hypothalamic lesion.

Hypernatremia Prognosis

The prognosis of this disorder depends on the underlying condition. Acute Hypernatremia is more dangerous than normal Hypernatremia which develops over a period of time. If cure is not done in time, the chance of survival is minimal in such cases. However normal and even chronic cases of this disorder are usually not life-threatening as the brain gets time to adjust to inflammation in such cases.

If you suspect yourself to be having Hypernatremia, get in touch with a medical care provider immediately. Timely treatment is very important for curing this disease, as is the case with many other conditions. This is a life-threatening disorder and may give rise to emergency situations. Proper medical care in time can help you avoid many discomforting complications and get back to health within a short time.

References:

http://www.nlm.nih.gov/medlineplus/ency/article/000394.htm

http://www.unitedhealthdirectory.com/diseases-and-conditions/hypernatremia/

http://emedicine.medscape.com/article/766683-overview

http://medical-dictionary.thefreedictionary.com/hypernatremia