Salt Toxicity: A Systematic Review and Case Reports

Metheny, Norma A.; Krieger, Mary

doi:10.1016/j.jen.2020.02.011

Cited by 22 publications

(16 citation statements)

References 28 publications

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“…Commonly, hypernatremia is usually caused by hypovolaemia due to water loss, either by increased loss or reduced intake. Rarely it can be due to sodium gain where notably there have been several case reports of salt-related poisoning ( 4 , 5 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Severe Hypernatremia From Ingestion of One's Own Urine

2022

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An often unrecognized cause of hypernatremia is the ingestion of fluids or substances with high osmolality. We hereby report a case of severe hypernatremia with acute kidney injury in a severely debilitated patient with acute gouty arthritis who resorted to ingesting his own urine. Hypernatremia induced by drinking urine could be attributed to many underlying mechanisms, one of the important possible causes is the resultant high serum urea that leads to significant osmotic diuresis and a further increase in free water clearance. To the best of our knowledge this is the first case report that describes this unique cause of hypernatremia.

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Section: Discussionmentioning

confidence: 99%

Case Report: Severe Hypernatremia From Ingestion of One's Own Urine

2022

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“…In the 2020 KDRIs, no potential indicators for adverse toxicological effects of sodium were identified subsequent to reviewing the available evidence after excluding the association of sodium intake with chronic disease related indicators. Lethal levels of dietary sodium, primarily due to the ingestion of acute doses, have been previously reported [ 20 21 22 ]. However, they were unsuitable for establishing a sodium UL since the levels did not necessarily reflect the toxicological effects of high sodium intake in our habitual diets.…”

Section: Intake–response Relationship and Specification Of Kdri Valuesmentioning

confidence: 99%

Dietary Reference Intakes of sodium for Koreans: focusing on a new DRI component for chronic disease risk reduction

et al. 2022

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Sodium is a physiologically essential nutrient, but excessive intake is linked to the increased risk of various chronic diseases, particularly cardiovascular. It is, therefore, necessary to accomplish an evidence-based approach and establish the Korean Dietary Reference Intakes (KDRIs) index, to identify both the nutritional adequacy and health effects of sodium. This review presents the rationale for and the process of revising the KDRIs for sodium and, more importantly, establishing the sodium Chronic Disease Risk Reduction Intake (CDRR) level, which is a new specific set of values for chronic disease risk reduction. To establish the 2020 KDRIs for dietary sodium, the committee conducted a systematic literature review of the intake–response relationships between the selected indicators for sodium levels and human chronic diseases. In this review, 43 studies published from January 2014 to December 2018, using databases of PubMed and Web of Science, were finally included for evaluating the risk of bias and strength of evidence (SoE). We determined that SoE of the relationship between dietary sodium and cardiovascular diseases, cerebrovascular disease, and hypertension, was moderate to strong. However, due to insufficient scientific evidence, we were unable to establish the estimated average requirement and the recommended nutrient intake for dietary sodium. Therefore, the adequate intake of sodium for adults was established to be 1,500 mg/day, whereas the CDRR for dietary sodium was established at 2,300 mg/day for adults. Intake goal for dietary sodium established in the 2015 KDRIs instead of the tolerable upper intake level was not presented in the 2020 KDRIs. For the next revision of the KDRIs, there is a requirement to pursue further studies on nutritional adequacy and toxicity of dietary sodium, and their associations with chronic disease endpoint in the Korean population.

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“…Cases of salt poisoning in children have been reported, both unintentional and intentional. Salt toxicity is dangerous and associated with significant (>50%) mortality due to irreversible neurological damage 26 . Renal impairment and the inability of children to communicate the need for fluids represent the main risk factors for salt toxicity.…”

Section: Clinical States With Sodium Excessmentioning

confidence: 99%

Diagnosis and management of hypernatraemia in children

Zieg

2021

Acta Paediatrica

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Hypernatraemia is most commonly caused by excessive loss of solute‐free water or decreased fluid intake; less often, the aetiology is salt intoxication. Especially infants, young children and individuals with a lack of access to water are at risk of developing hypernatraemia. Diagnosis is based on detailed history, physical examination and basic laboratory tests. Correction of hypernatraemia must be slow to prevent cerebral oedema and irreversible brain damage. This article reviews the aetiology, differential diagnosis and management of conditions associated with paediatric hypernatraemia. Distinguishing states with water deficiency from states with salt excess is important for proper management of hypernatraemic patients.

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Salt Toxicity: A Systematic Review and Case Reports

Cited by 22 publications

References 28 publications

Case Report: Severe Hypernatremia From Ingestion of One's Own Urine

Case Report: Severe Hypernatremia From Ingestion of One's Own Urine

Dietary Reference Intakes of sodium for Koreans: focusing on a new DRI component for chronic disease risk reduction

Diagnosis and management of hypernatraemia in children

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