Hyperosmolality

An abnormally high concentration of osmotically active solutes (primarily glucose, sodium, and urea) in body fluids above the normal serum range (275–295 mOsm/kg), resulting in increased plasma tonicity and potential cellular dehydration.

Causes

• Severe dehydration --> Hypernatremia

• Hyperosmolar hyperglycemic state --> hyperglycemia

• Diabetic ketoacidosis --> hyperglycemia

• Kidney failure  --> nitrogenous waste products --> uremia

• Severe infections/sepsis

• Medications

  • Corticosteroids

  • Thiazide diuretics

  • Atypical antipsychotics

  • β-blockers

• Excessive administration of hypertonic fluids

• Sodium overload