Hypernatremia in hepatic failure

Abstract

The presence of hypernatremia in patients with hepatic failure has not received major attention. The records of 25 patients hospitalized with decompensated liver disease (usually Laennec''s cirrhosis) were examined and hypernatremia was found in 15. Probable causes include increased insensible water losses, impairment of water intake due to encephalopathy, and the use of osmotic cathartics with hypotonic enteric losses. Patients in this series showing hypernatremia had a mortality of 87%. Mortality in those without hypernatremia was 60%. The presence of increased serum Na concentrations in patients with decompensated liver disease is an ominous but correctable abnormality reflecting a disturbance in water balance.