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Case Reports in Medicine
Volume 2014, Article ID 736073, 4 pages
Case Report

Hypernatremia: Correction Rate and Hemodialysis

1Wellesley College, 106 Central Street, Wellesley, MA 02481, USA
2Department of Internal Medicine, University of Arizona, 1501 N. Campbell Avenue, Tucson, AZ 85724, USA
3University of California Los Angeles, Los Angeles, CA 90095, USA
4Department of Nephrology, Yale-New Haven Hospital, P.O. Box 208029, New Haven, CT 06520, USA

Received 22 May 2014; Revised 13 October 2014; Accepted 18 October 2014; Published 9 November 2014

Academic Editor: Michael S. Firstenberg

Copyright © 2014 Saima Nur et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Severe hypernatremia is defined as serum sodium levels above 152 mEq/L, with a mortality rate ≥60%. 85-year-old gentleman was brought to the emergency room with altered level of consciousness after refusing to eat for a week at a skilled nursing facility. On admission patient was nonverbal with stable vital signs and was responsive only to painful stimuli. Laboratory evaluation was significant for serum sodium of 188 mmol/L and water deficit of 12.0 L. Patient was admitted to medicine intensive care unit and after inadequate response to suboptimal fluid repletion, hemodialysis was used to correct hypernatremia. Within the first fourteen hours, sodium concentration only changed 1 mEq/L with a fluid repletion; however, the concentration dropped greater than 20 mEq/L within two hours during hemodialysis. Despite such a drastic drop in sodium concentration, patient did not develop any neurological sequela and was at baseline mental status at the time of discharge.