Treatment of Hypernatremia with Serum Sodium 145–159 mmol/L

When serum sodium falls in the 145–159 mmol/L range, this represents mild-to-moderate hypernatremia requiring structured clinical assessment and targeted fluid management to safely restore sodium balance.

Clinical Scenario

Serum sodium 145–159 mmol/L (mild to moderate hypernatremia). The underlying cause is commonly a fluid deficit, and management depends on the patient's haemodynamic status and concurrent clinical factors.

Approach Overview

Oral and enteral routes are the preferred, safest means of fluid replacement. The complete protocol — including which intravenous fluid to select, how to prioritise haemodynamic stabilisation, and how concurrent conditions affect fluid choice — is detailed in the full regimen.

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References

HYPERnatraemia (Mild to Moderate: 145–159 mmol/L, Severe: more than 160 mmol/L)
Oral/enteral fluid replacement with water, is safest.
Often due to fluid deficit; correct haemodynamic instability first with sodium chloride 0.9%.
Intravenous fluids without added sodium (generally glucose 5%) may be needed.
In the setting of hyperglycaemia the preferred fluid of choice is sodium chloride 0.9%.

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