I am going to jump into some literature review here, and I'm so glad this study was done in the

Clinical Journal of American Society of Nephrology, and this is from May 2019.

And the name of this study is the rate of correction of hyperneetremia and health outcomes

in critically ill patients.

And as we all know, raising sodium too quickly in hyponetremia is very problematic because

you can cause CPM, central pontine myeloninininis. So in that situation, we watch the sodium

levels very closely and we try to raise the sodium slowly.

And for some reason, it has taken hold in adult practice of medicine

that the same thing needs to be done for hypernatremia

despite no evidence that that should be the case.

And I have noticed that for years, the super majority of my colleagues

that emit hypernatremia, which is a pretty common problem, particularly in dementia patients

and elderly, that either don't have access to water or very often are in a late stage of

dementia. It's really an end-of-life issue where they

stop drinking. But anyway, when they do admit these patients, they are doing Q-4-hour sodium

sometimes because they don't want to get the sodium level too low too quickly. And that's the

wrong thing to do. You know, Mark Twain said nothing so needs reforming

as other people's habits. I'm sure I have hundreds of habits that people would like to change

and for good reason. But as far as me being able to change other people's habits on hypernatremia,

it has been somewhat of a lost cause, despite places like up-to-date

and other sources of medical information taking my side on this for a while.

And this study of the Clinical Journal of American Society of Nephrology had a conclusion

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