Causes of hypernatraemia

Type

Aetiology

Urine

Low total body Na

Renal losses: diuretic excess, osmotic diuresis (glucose, urea, mannitol)

[Na + ] >20 mmol/l iso-or hypotonic

Extra-renal losses: excess sweating

[Na + ] <10 mmol/l hypertonic

Normal total body Na

Renal losses: diabetes insipidus

[Na + ] variable hypo-, iso- or hypertonic

Extra-renal losses: respiratory and renal insensible losses

[Na + ] variable hypertonic

Increased total body Na

Conn's syndrome, Cushing's syndrome, excess NaCl, hypertonic NaHCO3

[Na + ] >20 mmol/l iso-or hypertonic

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