Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Submit Manuscript
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • Topic/Program Collections
    • Blog
  • Multimedia
    • Teaching Slides
    • Pediatrics On Call Podcast
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in
  • My Cart

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • My Cart
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Submit Manuscript
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • Topic/Program Collections
    • Blog
  • Multimedia
    • Teaching Slides
    • Pediatrics On Call Podcast
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
  • Subscribe
  • Alerts
  • Careers
American Academy of Pediatrics
Commentary

Treating Hypernatremic Dehydration

Andrew L. Schwaderer and George J. Schwartz
Pediatrics in Review April 2005, 26 (4) 148-150; DOI: https://doi.org/10.1542/pir.26-4-148
Andrew L. Schwaderer
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
George J. Schwartz
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • Comments
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF
  1. Andrew L. Schwaderer, MD
  1. Fellow, Pediatric Nephrology
  1. George J. Schwartz, MD
  1. Professor of Pediatrics
    Chief, Division of Pediatric Nephrology
    University of Rochester School of Medicine & Dentistry
    Rochester, New York

In the November 2004 “Index of Suspicion,” Case 1 featured a patient who had hypernatremic dehydration. Dr Scott Hamilton raised the issue of which intravenous solution should be used to treat this condition, given the dangers inherent in lowering the serum sodium level too quickly.

Drs Schwaderer and Schwartz have written this commentary to guide clinicians through the complexities of this therapeutic challenge.

During most of January, an earlier version of this commentary was printed in the online edition of Pediatrics in Review. This amended version, which was substituted online in late January for the previous commentary, is the text that readers should consult because some corrections were made by the authors.

—LFN

Overview

Hypernatremia, a frequently encountered electrolyte disorder, is defined as a serum sodium level greater than 145 mEq/L (145 mmol/L) and represents a deficit of water in relation to total body sodium. Hypernatremic dehydration may be caused by pure water loss (diabetes insipidus), hypotonic fluid loss (vomiting or diarrhea), or hypertonic sodium gain (hypertonic feeding preparations such as improperly prepared infant formula). (1) Severe hypovolemic hypernatremic dehydration induces brain shrinkage, which can tear the cerebral blood vessels, leading to cerebral hemorrhage, seizures, paralysis, and encephalopathy. (2)(3) Infants who have severe hypernatremia (serum sodium, >160 mEq/L [160 mmol/L]) often present with muscle weakness, a high-pitched cry, insomnia, or lethargy. (1) Younger children tend to have both a higher morbidity and mortality with severe hypernatremia. (2)

Breastfeeding hypernatremic dehydration results when a mother-infant feeding interaction is inadequate. In this case, human milk production is limited, and the physiologic decline in human milk sodium concentration does not occur. (4) Forty cases of hypernatremia due to human milk failure have been described in the medical literature. …

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Pediatrics in Review: 26 (4)
Pediatrics in Review
Vol. 26, Issue 4
1 Apr 2005
  • Table of Contents
  • Index by author
View this article with LENS
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Treating Hypernatremic Dehydration
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
Treating Hypernatremic Dehydration
Andrew L. Schwaderer, George J. Schwartz
Pediatrics in Review Apr 2005, 26 (4) 148-150; DOI: 10.1542/pir.26-4-148

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Treating Hypernatremic Dehydration
Andrew L. Schwaderer, George J. Schwartz
Pediatrics in Review Apr 2005, 26 (4) 148-150; DOI: 10.1542/pir.26-4-148
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Print
Download PDF
Insight Alerts
  • Table of Contents

Jump to section

  • Article
    • Overview
    • Treatment
    • Conclusion
    • Clinical Example
    • Suggested Reading
  • Info & Metrics
  • Comments

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Index of Suspicion in the Nursery *
  • Google Scholar

More in this TOC Section

  • Hello 2021
  • Pediatrics in Review: Questions for the 41st Year
  • The Febrile Infant: Where Art Meets Science to Prevent Harm
Show more Commentary

Similar Articles

Subjects

  • Fetus/Newborn Infant
    • Fetus/Newborn Infant
  • Journal Info
  • Editorial Board
  • ABP Content Specifications Map
  • Overview
  • Licensing Information
  • Authors
  • Author Guidelines
  • Submit My Manuscript
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Contact Us
  • Subscribe
  • Resources
  • Media Kit
  • About
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • AAP.org
  • shopAAP
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
American Academy of Pediatrics

© 2021 American Academy of Pediatrics