Principal Causes of Hypernatremia
Description | Category | Examples |
|---|---|---|
Hypovolemic hypernatremia | ||
Decreased total body water (TBW) and sodium with a relatively greater decrease in TBW | Gastrointestinal losses | Diarrhea Vomiting |
Skin losses | Excessive sweating | |
Renal losses | Intrinsic renal disease Loop diuretics Osmotic diuresis (glucose, urea, mannitol) | |
Euvolemic hypernatremia | ||
Decreased TBW with near-normal total body sodium | Extrarenal losses from the respiratory tract | Tachypnea |
Extrarenal losses from the skin | Excessive sweating Fever | |
Renal losses | ||
Other | Inability to access water Primary hypodipsia Reset osmostat | |
Hypervolemic hypernatremia | ||
Increased sodium with normal or increased TBW | Hypertonic fluid administration | Hypertonic saline Sodium bicarbonate Total parenteral nutrition |
Mineralocorticoid excess | Adrenal tumors secreting deoxycorticosterone Congenital adrenal hyperplasia (caused by 11beta-hydroxylase defect) | |