Diagnosis and Management of Disorders of Body Tonicity-Hyponatremia and Hypernatremia: Core Curriculum 2020.

Journal Article (Journal Article;Review)

Overall body fluid concentration is regulated within a narrow range by the concerted action of the hypothalamic-pituitary axis to influence water intake through thirst and water excretion via the effect of vasopressin, or antidiuretic hormone, on renal collecting duct water permeability. Sodium is the principal extracellular cation; abnormalities in overall effective body fluid concentration, or tonicity, manifest as disturbances in serum sodium concentration. Depending on its severity and chronicity, hyponatremia can lead to significant symptoms, primarily related to central nervous system function. Failure to correct hyponatremia can lead to permanent neurologic damage, as can over rapid correction. It is thus essential to stay within specific limits for correction, particularly for chronic hyponatremia. Hypernatremia also leads to central nervous system dysfunction, although goals for its correction rate are less well established. This Core Curriculum article discusses the normal regulation of tonicity and serum sodium concentration and the diagnosis and management of hypo- and hypernatremia.

Full Text

Duke Authors

Cited Authors

  • Seay, NW; Lehrich, RW; Greenberg, A

Published Date

  • February 2020

Published In

Volume / Issue

  • 75 / 2

Start / End Page

  • 272 - 286

PubMed ID

  • 31606238

Electronic International Standard Serial Number (EISSN)

  • 1523-6838

Digital Object Identifier (DOI)

  • 10.1053/j.ajkd.2019.07.014


  • eng

Conference Location

  • United States