An audit on the management of hypernatremia in a district general hospital in the UK

There are no specific clinical features of hypernatremia (raised serum sodium). It is usually diagnosed incidentally on blood testing. Other biochemical parameters for renal function, hyperglycaemia and hypercalcaemia also need to be checked. The underlying cause of hypernatraemia needs to be identified and in the process the plasma and urine osmolalities need to be measured. Hypernatraemia can lead to serious complications including subarachnoid and subdural bleed resulting from rupture of bridging veins and dural sinus thrombosis, leading to brain damage or death. Also, rapid correction of chronic hypernatremia causes cerebral oedema, seizure, and brain damage. Therefore, proper management of hypernatraemia is very important and fluid management should correct both circulating volume & water deficits. Hypernatraemia should be corrected gradually over 48-72 hours, particularly in longer and unknown duration.