When your blood sodium gets too high, you’re dealing with hypernatremia, a condition where sodium levels in the blood rise above 145 mEq/L, often due to fluid loss or inadequate water intake. Also known as high serum sodium, it’s not just a lab number—it’s a signal your body is struggling to balance fluids, and it can turn dangerous fast. This isn’t rare. It shows up often in older adults, people with dementia who forget to drink, or those on diuretics and lithium. Even a few days without enough water can push sodium levels up, especially if you’re sweating, vomiting, or have kidney issues.
Hypernatremia doesn’t happen in a vacuum. It’s closely tied to dehydration, the loss of body water that forces sodium to concentrate in the bloodstream. It also links directly to kidney function, how well your kidneys can filter and retain water. If your kidneys can’t hold onto water—because of disease, aging, or drugs like diuretics—your sodium climbs. Some medications make this worse. Lithium, for example, can damage the kidneys’ ability to concentrate urine. Diuretics like furosemide flush out water but leave sodium behind. Even some antipsychotics and SSRIs can mess with your thirst signals, making you less likely to drink even when you need to.
What’s scary is how subtle hypernatremia can be at first. You might just feel tired, confused, or irritable. In older people, it’s often mistaken for dementia or depression. But if sodium keeps rising, you can develop seizures, coma, or permanent brain damage. The fix isn’t always just drinking more water—it’s figuring out why your body lost fluid in the first place. That’s why knowing which drugs are involved matters. It’s not just about treating the number, it’s about treating the root cause.
The posts below cover real-world scenarios where sodium balance gets disrupted—from how aging changes your body’s response to meds, to how kidney disease forces dose adjustments, to the hidden risks of combining certain drugs. You’ll find practical info on what to watch for, which medications to question, and how to protect yourself or a loved one before things get serious. This isn’t theory. It’s what happens in clinics, homes, and ERs when sodium gets out of line—and how to stop it before it’s too late.
Hyponatremia and hypernatremia are dangerous electrolyte imbalances in kidney disease, affecting up to 25% of CKD patients. Learn how kidney damage disrupts sodium balance, why common treatments can backfire, and how to manage them safely.