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Hyperosmolar Hyponatremia
Aka: Hyperosmolar Hyponatremia
- See Also
- Hyponatremia
- Normoosmolar Hyponatremia
- Hypoosmolar Hyponatremia
- Hyponatremia Management
- Sodium and Water Homeostasis
- Definition
- Hyponatremia with Measured Serum Osmolality >300 mOsm
- Pathophysiology
- Effective osmoles (e.g. excessive Glucose) create a hypertonic, hyperosmolar extracellular fluid
- Results in a transcellular shift of water out of cells into extracellular fluid
- Results in dilution of Sodium with Hyponatremia
- Causes
- Hypertonic infusion
- Glucose
- Mannitol
- Glycine
- Sorbitol
- Radiocontrast Material
- Hyperglycemia
- Associated Conditions
- Diabetic Ketoacidosis
- Hyperosmolar Hyperglycemic Nonketotic Coma
- Calculation
- Sodium falls 1.6 meq/L per 100 mg/dl Glucose rise above 100 mg/dl
- Sodium falls 2.4meq/L per 100 mg/dl Glucose rise above 400 mg/dl
- References
- Kone in Tisher (1993) Nephrology, p. 87-100
- Levinsky in Wilson (1991) Harrison's IM, p. 281-84
- Rose (1989) Acid-Base and Electrolytes, p. 601-38
- Braun (2015) Am Fam Physician 91(5): 299-307 [PubMed]