Systematic review and meta-analysis of the treatment of hypernatremia in adult hospitalized patients: impact on mortality, morbidity, and treatment-related side effects
Kitisin N, Raykateeraroj N, Hikasa Y, et al., 2025 · 12 studies included
Summary
Adult hospitalized hypernatremia meta-analysis evaluating correction speed and clinical outcomes. Overall, faster correction (>0.5 mmol/L/h) was not associated with significantly higher mortality; subgroup analyses suggested lower mortality in admission-related, early-treated, and severe hypernatremia, with high heterogeneity in several analyses.
Conclusion
Adult evidence does not validate a rigid pediatric-derived correction ceiling for all hypernatremia. No major neurologic complications were reported with correction rates <1 mmol/L/h in the included literature, but the evidence is observational/heterogeneous and does not establish a universal target rate.
Clinical Context & Relevant Topics (2)
Disease ReferenceTonicity assessment, etiologic classification, 3% hypertonic saline bolus protocols, individualized ODS-safe correction limits, DDAVP relowering, DI diagnostics, and evidence-aware hypernatremia correction.
ICU evaluation of hypotonic polyuria and hypernatremia with safe fluid replacement, desmopressin use, and differentiation of AVP deficiency from osmotic and nephrogenic causes.