Hypernatraemia in South African hospitalized patients
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
African Association of Nephrology
Abstract
Background: Hypernatraemia is a common electrolyte problem in hospitalized patients and is associated with a high
mortality rate. We determined the incidence, causes, management, and outcomes of hypernatraemia in adult
hospitalized patients at a large South African tertiary hospital.
Methods: A retrospective study was conducted at Tygerberg Hospital in Cape Town, South Africa. Adult patients
with hypernatraemia (at least one serum sodium concentration ≥150 mmol/L) during a 3-month period in 2014
were identified from our laboratory database for inclusion.
Results: There were 204 patients with hypernatraemia, a prevalence of 1.5%. Of these patients, 101 (49.5%) were
male, and the mean age was 53 years. There were 66 patients (32.4%) who had hypernatraemia on admission, and
138 who developed it during the course of their stay in hospital. The overall in-hospital mortality was 38.7%, with
higher rates for older patients and those with more severe degrees of hypernatraemia. Contributory causes which
were most commonly present included dehydration/hypovolaemia (45%), followed by sepsis (39%). Net sodium
gain, rather than water deficit, was identified as the main mechanism in most of the patients who developed hypernatraemia
in the intensive care units. We found little evidence of any diagnostic work-up and also found that the
details of fluid therapy and intake–output charting were poorly documented.
Conclusions: There is a very high mortality rate in our hospitalized patients with hypernatraemia. The diagnostic
work-up and therapy were often inadequate or poorly documented. The management of this important condition
needs to be improved with the aid of standardized protocols.
Description
CITATION: Abohajir, A., Rensburg, M. A. & Davids, M. R. 2019. Hypernatraemia in South African hospitalized patients. African Journal of Nephrology, 22(1):12-16, doi:10.21804/22-1-3285.
The original publication is available at http://www.journals.ac.za/index.php/ajn/
The original publication is available at http://www.journals.ac.za/index.php/ajn/
Keywords
Hypernatraemia, Water-electrolyte imbalances, Sodium -- Metabolism -- Disorders
Citation
Abohajir, A., Rensburg, M. A. & Davids, M. R. 2019. Hypernatraemia in South African hospitalized patients. African Journal of Nephrology, 22(1):12-16, doi:10.21804/22-1-3285