American Journal of Kidney Diseases
Volume 54, Issue 4 , Pages 674-679 , October 2009

Tonicity Balance in Patients With Hypernatremia Acquired in the Intensive Care Unit

  • Gregor Lindner, MD

      Affiliations

    • Department of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
    • Corresponding Author InformationAddress correspondence to Gregor Lindner, MD, Department of Nephrology and Dialysis, Medical University of Vienna, Waehringerguertel 18-20, 1090 Wien, Austria
    • ,
  • Nikolaus Kneidinger, MD

      Affiliations

    • Department of Medicine II, University Giessen Lung Center, Giessen, Germany
    • ,
  • Ulrike Holzinger, MD

      Affiliations

    • Intensive Care Unit 13H1, Medical University of Vienna, Vienna, Austria
    • ,
  • Wilfred Druml, MD

      Affiliations

    • Department of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
    • ,
  • Christoph Schwarz, MD

      Affiliations

    • Krankenhaus der Elisabethinen, Linz, Austria

Received 10 November 2008 ,Accepted 3 April 2009.

References 

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  2. Palevsky PM, Bhagrath R, Greenberg A. Hypernatremia in hospitalized patients. Ann Intern Med. 1996;124:197–203
  3. Lindner G, Funk GC, Schwarz C, et al. Hypernatremia in the critically ill is an independent risk factor for mortality. Am J Kidney Dis. 2007;50:952–957
  4. Aiyagari V, Deibert E, Diringer MN. Hypernatremia in the neurologic intensive care unit: How high is too high?. J Crit Care. 2006;21:163–172
  5. Hoorn EJ, Betjes MG, Weigel J, Zietse R. Hypernatraemia in critically ill patients: Too little water and too much salt. Nephrol Dial Transplant. 2008;23:1562–1568
  6. Halperin ML, Bohn D. Clinical approach to disorders of salt and water balance (Emphasis on integrative physiology). Crit Care Clin. 2002;18:249–272
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  9. Carlotti AP, Bohn D, Mallie JP, Halperin ML. Tonicity balance, and not electrolyte-free water calculations, more accurately guides therapy for acute changes in natremia. Intensive Care Med. 2001;27:921–924
  10. Nguyen MK, Kurtz I. New insights into the pathophysiology of the dysnatremias: A quantitative analysis. Am J Physiol Renal Physiol. 2004;287:F172–F180
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  12. Spira A, Gowrishankar M, Halperin ML. Factors contributing to the degree of polyuria in a patient with poorly controlled diabetes mellitus. Am J Kidney Dis. 1997;30:829–835
  13. Palevsky PM. Hypernatremia. Semin Nephrol. 1998;18:20–30
  14. Polderman KH, Schreuder WO, Strack van Schijndel RJ, Thijs LG. Hypernatremia in the intensive care unit: An indicator of quality of care?. Crit Care Med. 1999;27:1105–1108
  15. Liamis G, Tsimihodimos V, Doumas M, Spyrou A, Bairaktari E, Elisaf M. Clinical and laboratory characteristics of hypernatraemia in an internal medicine clinic. Nephrol Dial Transplant. 2008;23:136–143
  16. Moritz ML, Ayus JC. Hospital-acquired hyponatremia—Why are hypotonic parenteral fluids still being used?. Nat Clin Pract Nephrol. 2007;3:374–382

 Originally published online as doi: 10.1053/j.ajkd.2009.04.015 on June 11, 2009.

PII: S0272-6386(09)00647-7

doi: 10.1053/j.ajkd.2009.04.015

American Journal of Kidney Diseases
Volume 54, Issue 4 , Pages 674-679 , October 2009

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