Hypertonicity: Clinical entities, manifestations and treatment

Figure 6 Mean values of [Na]_S, [Glu]_S and serum tonicity in hyperglycemia in patients on chronic dialysis. The figure shows the mean values of [Na]_S, [Glu]_S and tonicity in 148 episodes of severe episodes of severe hyperglycemia treated only with insulin infusion[40]. A: Values recorded at presentation with hyperglycemia; B: Values predicted by the corrected [Na]_S[47]; C: Values of observed [Na]_S and [Glu]_S and calculated tonicity at the end of treatment when [Glu]_S had declined to desired levels. Tonicity was calculated as [Glu]_S + 2 × [Na]_S in A, B and C. The average level of tonicity after treatment predicted by the use of predicted [Na]_S (B) was very close to the corresponding measured level (C).