2014-18 Treatment of Hypernatremia Hypernatremia occurs in predictable clinical settings, llowing opportunities for prevention Route: mouth or via a nasogastric tube or 5% uncontrolled diabetes Low salt diet low-dose thiazide diuretics Drugs that stimulate AVP section or enhance its action Water deficit should be corrected slowly over 48 72h. The plasma Na concentration be lowered by 0.5 mmol/,/h and by no more than 12 mmol/ L over the Water and electrolytes disturbances Sodium balance Water balance Potassium balance Potassium balance K intake: 1 mmol/kg/d Distribution of Total Body Potassium in Organs Immediately following a meal, most K enter and Body Compartments excretion 4 mmoll2014-1-8 9 Treatment of Hypernatremia • Hypernatremia occurs in predictable clinical settings, allowing opportunities for prevention – recovery from acute kidney injury, – catabolic states, – therapy with hypertonic solutions, – uncontrolled diabetes – burns • Water deficit should be corrected slowly over 48 – 72h. The plasma Na concentration be lowered by 0.5 mmol/l/h and by no more than 12 mmol/L over the 1 st 24h • Route: mouth or via a nasogastric tube or 5% dextrose or half-isotonic saline iv • CDI – Desmopressin – Low salt diet + low-dose thiazide diuretics – Drugs that stimulate AVP section or enhance its action Water and electrolytes disturbances • Sodium balance – Hypovolemia • Water balance – Hyponatremia – Hypernatremia • Potassium balance – Hypokelemia – hyperkelemia Potassium balance • K intake: 1 mmol/kg/d • Immediately following a meal, most K enter cells (plasma K, insulin, catecholamine) • Steady state, K ingestion matches with excretion