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Severe Hypernatremia in Cystic Fibrosis

JOHN R. CARLILE, MD; DIANE M. PAFFORD, MPH, RD; WILLIAM W. WARING, MD
Am J Dis Child. 1983;137(7):702-703. doi:10.1001/archpedi.1983.02140330084024.
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The sweat of patients with cystic fibrosis (CF) has elevated levels of sodium and chloride compared with that of nonaffected persons. The quantities of electrolytes lost in sweat may be of considerable magnitude,1,2 and are dependent on sweat electrolyte concentration and volume.

Frequently observed hypochloremia in patients with CF living in the New Orleans area necessitates the use of salt supplementation. Excessive supplementation resulted in life-threatening hypernatremia in one patient. We wish to alert physicians to this complication of salt supplementation. Additionally, we polled all designated CF centers to determine a consensus regarding the practice of salt supplementation.

Responses From 51 CF Centers on Recommended Daily Amount of Salt Supplementation for Infants* Response No. of Centers Amount not specified† 25 1 g/day 11 1-2 g/day 5 0.5-1 g/day 3 Determined by serum electrolytes 3 1 mEq/kg/day 1 2-3 times maintenance sodium 1 Equal to maintenance sodium 1 "Pinch," ie,

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