Clinical Review: Improving the Clinical Management of Hypernatremic Dehydration

From The Department of Pediatrics, Montefiore Hospital and Medical Center, and The Albert Einstein College of Medicine, 111 East 210th Street, The Bronx, New York 10467. Correspondence to: Warren N. Rosenfeld, M.D., Department of Pediatrics, University of Kansas Medical Center, 39th and Rainbow Boulevard, Kansas City, Kansas 66103. SINCE THE ORIGINAL DESCRIPTION of hypernatremic dehydration over 25 years ago, our understanding of the pathogenesis and therapy of hypernatremia has led to a great reduction in the morbidity and mortality associated with this disorder. The unique fluid and osmolar changes make this entity more difficult to recognize and treat clinically than the more common isotonic dehydration. In hypernatremic dehydration, the loss of hypotonic fluids from the extracellular space results in a relative rise in extracellular ions (Fig. 1 }. ’ Sodium is the main extracellular cation, and serum sodium concentrations may ‘