Pediatrics in Review
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(Pediatrics in Review. 2009;30:412-413. doi:10.1542/10.1542/pir.30-10-412)
© 2009 American Academy of Pediatrics
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In Brief

Hypernatremia

The first 20% of the full text of this article appears below.

Common Electrolyte Problems in Pediatrics—Hypernatremia. Perkin R, Swift J. In: Pediatric Hospital Medicine. 2nd ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2008:89 –90

Disorders of Sodium and Water Homeostasis. Skorecki K, Ausiello D. In: Cecil's Medicine. 23rd ed. Philadelphia, Pa: Saunders, Inc; 2007

The Changing Pattern of Hypernatremia in Hospitalized Children. Moritz ML, Ayus JC. Pediatrics. 1999;104 :435 –439[Abstract/Free Full Text]

Urine Sodium Concentration in Ambulatory Healthy Children: Hypotonic or Isotonic? Moritz ML. Pediatr Nephrol. 2008;23 :955 –957[CrossRef][Medline]

Breastfeeding-associated Hypernatremia: Are We Missing the Diagnosis? Moritz ML, Manole MD, Bogen DL, Ayus JC. Pediatrics. 2005;116 :e343 –e347[Abstract/Free Full Text]

Preventing Neurological Complications from Dysnatremias in Children. Moritz ML, Ayus JC. Pediatr Nephrol. 2005;20 :1687 –1700[CrossRef][Medline]

Hypernatremia is defined as a serum sodium concentration of greater than 145 mEq/L (145 mmol/L). This state constitutes an important electrolyte abnormality that requires rapid clinical assessment and intervention to prevent deterioration and complications. Serum sodium values greater than 160 mEq/L (160 mmol/L) require immediate attention.

Hypernatremia most commonly indicates a deficiency of total body water relative to total body solute. This imbalance can be caused by three basic mechanisms: 1) water losses, including gastrointestinal, insensible, or renal; 2) inadequate water intake; and 3) excessive sodium intake, either oral or parenteral, or mineralocorticoid excess.

Hypernatremia historically has been associated with dehydration caused by diarrhea, usually found in children younger than 12 months of age. Several studies have shown that ineffective breastfeeding, particularly by first-time mothers, can . . . [Full Text of this Article]


David A. Goff, MD
Valeria Higinio, MD
 Brody School of Medicine
East Carolina University
Greenville, NC

Janet R. Serwint, MD, Consulting Editor
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