Skip to main content

Impact of hypernatremia, hyponatremia and their comparison on ICU mortality


Serum sodium homeostasis is important in the critically ill patient [13]. We studied the effect of hypernatremia, hyponatremia and their comparison on ICU mortality in our patient population.


We studied 274 patients hospitalized in a general ICU of a major teaching hospital in Tehran, Iran, cross-sectionally, between 2004 and 2006. Patients' biographical data, reasons for admission, hyponatremia (sodium less than 135 mEq/l) and hypernatremia (sodium more than 145 mEq/l) during the ICU stay were recorded and their effects on mortality were assessed.


The mortalities of patients with hyponatremia (34.33% versus 15.37% with OR = 5.69 and 95% CI from 2.87 to 11.30) and with hypernatremia (55.17% versus 17.78% with OR = 2.80 and 95% CI from 1.43 to 5.49) were significantly higher than patients without it. The mean age of patients with sodium imbalance was higher compared with those without it (hypo-natremia and hypernatremia 52.25 ± 21.12 vs. 44.40 ± 20.28 years and 55.59 ± 19.69 vs. 48.52 ± 21.83 years, respectively). Mortality was significantly higher in hypernatremic compared with hyponatremic patients (55.2% vs. 34.3%, respectively, 95% CI from 7.7% to 33.9%; P = 0.0034).


Serum sodium imbalances carry unacceptably high mortality [4]. Patients with hypernatremia showed higher ICU mortality as compared with those with hyponatremia.


  1. Kraft MD, Btaiche IF, Sacks GS, Kudsk KA: Treatment of electrolyte disorders in adult patients in the intensive care unit. Am J Health Syst Pharm 2005, 62: 1663-1682. 10.2146/ajhp040300

    Article  CAS  Google Scholar 

  2. Zilberberg MD, Exuzides A, Spalding J, Foreman A, Jones AG, Colby C, et al.: Epidemiology, clinical and economic outcomes of admission hyponatremia among hospitalized patients. Curr Med Res Opin 2008, 24: 1601-1608. 10.1185/03007990802081675

    Article  Google Scholar 

  3. Patel GP, Balk RA: Recognition and treatment of hyponatremia in acutely ill hospitalized patients. Clin Ther 2007, 29: 211-229. 10.1016/j.clinthera.2007.02.004

    Article  CAS  Google Scholar 

  4. Lindner G, Funk GC, Schwarz C, Kneidinger N, Kaider A, Schneeweiss B, et al.: Hypernatremia in the critically ill is an independent risk factor for mortality. Am J Kidney Dis 2007, 50: 952-957. 10.1053/j.ajkd.2007.08.016

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

Reprints and Permissions

About this article

Cite this article

Mokhtari, M., Kouchek, M., Miri, M. et al. Impact of hypernatremia, hyponatremia and their comparison on ICU mortality. Crit Care 13 (Suppl 1), P455 (2009).

Download citation

  • Published:

  • DOI:


  • Public Health
  • Sodium
  • Patient Population
  • High Mortality
  • Emergency Medicine