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Box 85.1

Disorders of Plasma Sodium Concentration

Plasma sodium concentration (mmol/L)ClassificationClinical features
>155Severe hypernatraemiaDelirium, reduced conscious level, coma
150–155Moderate hypernatraemiaMuscle weakness, delirium
143–150Mild hypernatraemiaTypically asymptomatic
138–143Normal range
130–138Mild hyponatraemiaTypically asymptomatic
125–130Moderate hyponatraemiaHeadache, nausea, vomiting, muscle weakness, lethargy, delirium
<125Severe hyponatraemiaDelirium, ataxia, reduced conscious level, respiratory failure and seizures (reflecting cerebral oedema), especially when hyponatraemia has developed within 48 h.