Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Pediatric Hypernatremia Follow-up

  • Author: Ewa Elenberg, MD, MEd; Chief Editor: Timothy E Corden, MD  more...
 
Updated: Feb 13, 2014
 

Further Outpatient Care

Treat the underlying disease.

Restrict sodium and protein intake.

Next

Patient Education

Parents and caregivers should avoid making oral rehydration solutions at home or adding salt to any commercial infant formula.

Parents, especially breastfeeding mothers, should watch for neonatal dehydration and perinatal care.

The breastfed infant should be routinely monitored during the first weeks of life.[5]

In patients with diabetes insipidus, the following is indicated:

  • Monitor weight and urine output because clinically significant changes in sodium values are associated with changes in weight.
  • Restrict sodium and protein intake.
  • The patient should drink liberal amounts of water.
  • The patient and parents should ensure thirst develops before taking or giving medications.
Previous
Next

Deterrence/Prevention

Parents and caregivers should avoid making oral rehydration solutions at home or adding salt to any commercial infant formula.

Treat the underlying cause.

Previous
 
Contributor Information and Disclosures
Author

Ewa Elenberg, MD, MEd Associate Professor of Pediatrics, Renal Section, Texas Children's Hospital, Baylor College of Medicine

Ewa Elenberg, MD, MEd is a member of the following medical societies: American Society of Nephrology, American Society of Pediatric Nephrology

Disclosure: Nothing to disclose.

Coauthor(s)

Muthukumar Vellaichamy, MD, FAAP Clinical Assistant Professor, Department of Pediatrics, Wesley Medical Center, University of Kansas School of Medicine-Wichita

Muthukumar Vellaichamy, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Barry J Evans, MD Assistant Professor of Pediatrics, Temple University Medical School; Director of Pediatric Critical Care and Pulmonology, Associate Chair for Pediatric Education, Temple University Children's Medical Center

Barry J Evans, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Chief Editor

Timothy E Corden, MD Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin

Timothy E Corden, MD is a member of the following medical societies: American Academy of Pediatrics, Phi Beta Kappa, Society of Critical Care Medicine, Wisconsin Medical Society

Disclosure: Nothing to disclose.

Additional Contributors

G Patricia Cantwell, MD, FCCM Professor of Clinical Pediatrics, Chief, Division of Pediatric Critical Care Medicine, University of Miami Leonard M Miller School of Medicine/ Holtz Children's Hospital, Jackson Memorial Medical Center; Medical Director, Palliative Care Team, Holtz Children's Hospital; Medical Manager, FEMA, South Florida Urban Search and Rescue, Task Force 2

G Patricia Cantwell, MD, FCCM is a member of the following medical societies: American Academy of Hospice and Palliative Medicine, American Academy of Pediatrics, American Heart Association, American Trauma Society, National Association of EMS Physicians, Society of Critical Care Medicine, Wilderness Medical Society

Disclosure: Nothing to disclose.

References
  1. Conley SB. Hypernatremia. Pediatr Clin North Am. 1990 Apr. 37(2):365-72. [Medline].

  2. Abramovici MI, Singhal PC, Trachtman H. Hypernatremia and rhabdomyolysis. J Med. 1992. 23(1):17-28. [Medline].

  3. Yang TY, Chang JW, Tseng MH, Wang HH, Niu DM, Yang LY. Extreme hypernatremia combined with rhabdomyolysis and acute renal failure. J Chin Med Assoc. 2009 Oct. 72(10):555-8. [Medline].

  4. [Guideline] Mentes JC. Hydration management. Iowa City (IA): University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core; 2004 Feb. [Full Text].

  5. Konetzny G, Bucher HU, Arlettaz R. Prevention of hypernatraemic dehydration in breastfed newborn infants by daily weighing. Eur J Pediatr. 2008 Sep 26. [Medline].

  6. Adrogue HJ, Madias NE. Hypernatremia. N Engl J Med. 2000 May 18. 342(20):1493-9. [Medline].

  7. Avner ED. Clinical disorders of water metabolism: hyponatremia and hypernatremia. Pediatr Ann. 1995 Jan. 24(1):23-30. [Medline].

  8. Berl T. Disorders of water metabolism. Schrier RW, ed. Renal and Electrolyte Disorders. 5th ed. Lippincott-Raven; 1997.

  9. Brown RG. Disorders of water and sodium balance. Postgrad Med. 1993 Mar. 93(4):227-8, 231-4, 239-40 passim. [Medline].

  10. DeVita MV, Michelis MF. Perturbations in sodium balance. Hyponatremia and hypernatremia. Clin Lab Med. 1993 Mar. 13(1):135-48. [Medline].

  11. Finberg L. Hypernatremic (hypertonic) dehydration in infants. N Engl J Med. 1973 Jul 26. DA - 19730822(4):196-8. [Medline].

  12. Ho L, Bradford BJ. Hypernatremic dehydration and rotavirus enteritis. Clin Pediatr (Phila). 1995 Aug. 34(8):440-1. [Medline].

  13. Lin M, Liu SJ, Lim IT. Disorders of water imbalance. Emerg Med Clin North Am. 2005 Aug. 23(3):749-70, ix. [Medline].

  14. Molteni KH. Initial management of hypernatremic dehydration in the breastfed infant. Clin Pediatr (Phila). 1994 Dec. 33(12):731-40. [Medline].

  15. Moritz ML, Ayus JC. Preventing neurological complications from dysnatremias in children. Pediatr Nephrol. 2005 Dec. 20(12):1687-700. [Medline].

  16. Moritz ML, Ayus JC. The changing pattern of hypernatremia in hospitalized children. Pediatrics. 1999 Sep. 104(3 Pt 1):435-9. [Medline].

  17. Moritz ML, Manole MD, Bogen DL, Ayus JC. Breastfeeding-associated hypernatremia: are we missing the diagnosis?. Pediatrics. 2005 Sep. 116(3):e343-7. [Medline].

  18. Palevsky PM. Hypernatremia. Semin Nephrol. 1998 Jan. 18(1):20-30. [Medline].

  19. Paneth N. Hypernatremic dehydration of infancy: an epidemiologic review. Am J Dis Child. 1980 Aug. 134(8):785-92. [Medline].

  20. Peker E, Kirimi E, Tuncer O, Ceylan A. Severe hypernatremia in newborns due to salting. Eur J Pediatr. 2010 Jul. 169(7):829-32. [Medline].

  21. Roscelli JD, Yu CE, Southgate WM. Management of salt poisoning in an extremely low birth weight infant. Pediatr Nephrol. 1994 Apr. 8(2):172-4. [Medline].

  22. Trachtman H. Cell volume regulation: a review of cerebral adaptive mechanisms and implications for clinical treatment of osmolal disturbances: II. Pediatr Nephrol. 1992 Jan. 6(1):104-12. [Medline].

  23. Unal S, Arhan E, Kara N, Uncu N, Aliefendioglu D. Breast-feeding-associated hypernatremia: retrospective analysis of 169 term newborns. Pediatr Int. 2008 Feb. 50(1):29-34. [Medline].

  24. Visser L, Devuyst O. Physiopathology of hypernatremia following relief of urinary tract obstruction. Acta Clin Belg. 1994. 49(6):290-5. [Medline].

Previous
Next
 
Figure A: Normal cell. Figure B: Cell initially responds to extracellular hypertonicity through passive osmosis of water extracellularly, resulting in cell shrinkage. Figure C: Cell actively responds to extracellular hypertonicity and cell shrinkage in order to limit water loss through transport of organic osmolytes across the cell membrane, as well as through intracellular production of these osmolytes. Figure D: Rapid correction of extracellular hypertonicity results in passive movement of water molecules into the relatively hypertonic intracellular space, causing cellular swelling, damage, and ultimately death.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.