Sodium Imbalances: Causes and Manifestations |
Hypernatremia (Na+ >145 mEq/L [mmol/L]) | Hyponatremia (Na+ <135 mEq/L [mmol/L]) |
Disease |
- Diabetes insipidus
- Primary hyperaldosteronism
- Cushing syndrome
- Uncontrolled diabetes mellitus
| - SIADH
- Heart failure
- Primary hypoaldosteronism
- Cirrhosis
|
Cause |
Excessive Sodium Intake | Excessive Sodium Loss |
- IV fluids: hypertonic NaCl, excessive isotonic NaCl, IV sodium bicarbonate
| - GI losses: diarrhea, vomiting, fistulas, NG suction
|
- Hypertonic tube feedings without water supplements
| - Renal losses: diuretics, adrenal insufficiency, Na+ wasting renal disease
|
- Near-drowning in salt water
| - Skin losses: burns, wound drainage
|
|
Inadequate Water Intake | Inadequate Sodium Intake |
- Unconscious or cognitively impaired individuals
| |
| |
Excessive Water Loss (Increased sodium concentration) | Excessive Water Gain (Decrease sodium concentration) |
- Increased Insensible water loss (high fever, heatstroke, prolonged hyperventilation)
| - Excessive hypotonic IV fluids
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