Management of Hypernatremia

• Correct intravascular volume depletion with NS +/- K

• Replace free water deficit (50% in 1st 24 hours, no more than 0.5 mOsm/hr)

• Replace ongoing free water losses

• Treat underlying cause:

• Desmopression for CDI

• No specific Rx for NDI (reduce urine output with Na restriction, thiazides, or supratherapeutic DDAVP: potentiate ADH with NSAIDS