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Best Pract Res Clin Endocrinol Metab. 2016 Mar;30(2):189-203. doi: 10.1016/j.beem.2016.02.014. Epub 2016 Mar 4.

Diagnosis and treatment of hypernatremia.

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Renal Division, Brigham and Women's Hospital, Boston, MA, USA.
Renal Division, Brigham and Women's Hospital, Boston, MA, USA; Veterans Affairs Boston Healthcare System, Boston, MA, USA. Electronic address:


Hypernatremia is defined as a serum sodium level above 145 mmol/L. It is a frequently encountered electrolyte disturbance in the hospital setting, with an unappreciated high mortality. Understanding hypernatremia requires a comprehension of body fluid compartments, as well as concepts of the preservation of normal body water balance. The human body maintains a normal osmolality between 280 and 295 mOsm/kg via Arginine Vasopressin (AVP), thirst, and the renal response to AVP; dysfunction of all three of these factors can cause hypernatremia. We review new developments in the pathophysiology of hypernatremia, in addition to the differential diagnosis and management of this important electrolyte disorder.


TRPV1; diabetes insipidus; hypernatremia; lithium; osmoreceptor; vasopressin

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