We have previously shown that rabbits with hypernatremia develop significant hyperglycemia and that treatment with oral glucose containing solutions results in a substantial mortality (Ayus, J.C. JASN 1996; 7:1347). In order to evaluate the association between hyperglycemia and hypernatremia in humans, we retrospectively reviewed the records of non-diabetic patients admitted to a large urban children's hospital from Jan 92 through Dec 94, with a diagnosis of hypernatremia (SNa >150 mEq/L). 65 admissions in 59 patients were reviewed. The average patient age was 3.7 years(range 1d-19.7 y). The relationship between SNa and SGlu is shown in the table. 49% of admissions (32/65) had documented hyperglycemia (SGlu > 150 mg/dl). Peak SNa was not different for hyperglycemic and normoglycemic patients. The overall mortality for the group was 15% (9/59); 78% (7/9) of those were hyperglycemic. Hyperglycemia tended to be associated with increased mortality during hospitalization (p=0.067). Peak SGlu was higher in patients who died than in patients who survived (356mg/dl v. 177mg/dl, p<0.01). We conclude from this study that: 1) Hypernatremia has a significant hyperglycemic effect. 2) Hyperglycemia resolves with treatment for hypernatremia. 3) Mortality in hypernatremia occurs in patients most severely affected with hyperglycemia.

Table 1
Full size table