Hypernatremia
Hypernatremia: Excerpt from A Pocket Manual of Differential Diagnosis
Pure Water Loss
Inability to obtain or swallow water (e.g., coma, dementia, infancy)
Impaired thirst drive (e.g., hypothalamic lesion)
Increased insensible loss
Excessive Sodium Intake
Iatrogenic sodium administration
Sodium bicarbonate (cardiopulmonary resuscitation, treatment of lactic acidosis)
Accidental or deliberate ingestion of large quantities of sodium
Seawater ingestion or drowning
Mineralocorticoid or glucocorticoid excess
Primary aldosteronism
Cushing's syndrome
Ectopic ACTH production
Loss of Water in Excess of Sodium (without Concomitant Water Intake)
Gastrointestinal loss (e.g., vomiting, diarrhea, intestinal fistula)
Renal loss
Central diabetes insipidus
Head trauma
Posthypophysectomy
Neoplasm
Granulomatous disease (e.g., sarcoidosis, tuberculosis, Wegener's granulomatosis, syphilis, histiocytosis)
Central nervous system infection
Vascular lesion (e.g., cerebrovascular accident, aneurysm, sickle cell disease, Sheehan's syndrome)
Congenital
Impaired renal concentrating ability
Osmotic diuresis
Diabetic ketoacidosis
Chronic renal failure, especially interstitial disease (e.g., polycystic disease, medullary cystic disease)
Partial urinary tract obstruction, postobstructive diuresis
Diuretic phase of acute renal failure
Mannitol
Tube feedings
Infant formula (especially cow's milk)
Excessive diuretic use
Hypokalemia
Hypercalcemia
Decreased protein intake
Prolonged, excessive water intake
Sickle cell disease or trait
Multiple myeloma
Amyloidosis
Sarcoidosis
Sjögren's syndrome
Nephrogenic diabetes insipidus, congenital
Drugs
Alcohol
Diuretics
Lithium
Demeclocycline
Phenytoin
Propoxyphene
Sulfonylureas
Amphotericin B
Methoxyflurane
Colchicine
Vinblastine
Foscarnet
Skin loss (e.g., burns, sweating)
Peritoneal dialysis
Essential Hypernatremia (Reset Osmostat)
References
1. Ross EJ, Christie SBM: Hypernatremia.
Medicine 48:441, 1969.
2. Berl T, Schrier RW: Disorders of Water Metabolism, p. 1. See Bibliography, 4.
Book Source Details
- Book Title: A Pocket Manual of Differential Diagnosis
- Author(s): Stephen N. Adler, Dianne B. Gasbarra
- Year of Publication: 1999
- Copyright Details: A Pocket Manual of Differential Diagnosis, Copyright © 1999 Lippincott Williams & Wilkins.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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HYPERNATREMIA (Differential Diagnosis in Primary Care)
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