From the Guidelines
A sodium level of 160 mmol/L is considered severely elevated and requires immediate medical attention to prevent serious complications, including seizures, brain damage, or death. Normal sodium levels typically range between 135-145 mmol/L, and a reading of 160 indicates hypernatremia. This condition can cause symptoms like extreme thirst, confusion, muscle weakness, and in severe cases, life-threatening complications. Hypernatremia often results from dehydration, certain medications, excessive sodium intake, or medical conditions affecting water regulation in the body. According to the EASL clinical practice guidelines for the management of patients with decompensated cirrhosis 1, the management of hyponatremia and hypernatremia requires careful consideration of the underlying cause and appropriate treatment plan. While the guidelines primarily focus on hyponatremia, they emphasize the importance of correcting sodium imbalances to prevent serious complications. Key considerations in managing hypernatremia include:
- Carefully administered intravenous fluids to gradually lower sodium levels
- Determining the underlying cause of the elevated sodium level
- Addressing any underlying conditions contributing to the elevated sodium level
- Avoiding rapid correction of sodium levels to prevent brain swelling In clinical practice, it is essential to prioritize the correction of sodium imbalances, like a sodium level of 160 mmol/L, to prevent morbidity, mortality, and improve quality of life. Therefore, if you or someone has a sodium level of 160, seek immediate medical care to determine the underlying cause and appropriate treatment plan.
From the Research
Definition and Classification of Hypernatremia
- Hypernatremia is defined as a serum sodium concentration exceeding 145 mmol/L, with normal range being 136 - 145 mmol/L 2.
- When the serum sodium level surpasses 160 mmol/L and 190 mmol/L, it is classified as severe and extreme hypernatremia, respectively 2.
Risks and Complications of Hypernatremia
- Extreme hypernatremia is an uncommon occurrence and is associated with significant risks of mortality and morbidity 2.
- Hypernatremia can lead to altered mental status, ventriculomegaly, and other complications 2, 3.
- Rapid correction of sodium levels can lead to pontine myelinolysis, emphasizing the need for careful management 4.
Causes and Treatment of Hypernatremia
- The most frequently reported causes of extreme hypernatremia are accidental or intentional salt ingestion and diabetes insipidus, while dehydration due to poor water intake is a rare trigger 2.
- Essential hypernatremia is a rare condition characterized by chronic and sustained hypernatremia, absence of thirst, and normal renal function 3.
- Desmopressin acetate has been shown to be an effective treatment for essential hypernatremia, relieving adypsia, hypernatremia, and hyperosmolality 3.
- Accurate diagnosis and appropriate treatment of hypernatremia are crucial, as undercorrection or overcorrection can lead to poor patient prognosis 5, 6.