Hypernatremia with edema

Hypernatremia is usually associated with water depletion. Seven very ill pa tients developed hypernatremia in association with marked edema during ther apy in the hospital. All patients had hypoalbuminemia and azotemia. At the time of hypernatremia, urine output averaged 1880 mL/24 h and urine sodium concentration averaged 59 mmol/L, suggesting that low levels of antidiureti c hormone and/or a diminished effect of this hormone on the nephron may con tribute to the pathophysiological mechanism of the hypernatremia. Recogniti on of this salt- and water-overloaded state should guide therapy.