Hyperhydration

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Classification according to ICD-10
E87.7 Excess fluid
ICD-10 online (WHO version 2019)

Overhydration (also called hyperhydration ) or overhydration describes an excess volume of the extracellular fluid , which also includes the blood plasma . The cause is a disruption of the volume balance (excess sodium and water) or osmoregulation (isolated excess water). It occurs as a pathological condition with heart failure , kidney disease, hormonal disorders or excessive intake (through drinking or infusions ). In the case of certain chemotherapies , however, it is also brought about therapeutically by infusions in order to prevent kidney damage from the therapy.

Severe forms of overhydration can be treated with dialysis procedures such as hemofiltration ( continuous veno-venous hemofiltration (CVVH) or continuous arteriovenous hemofiltration (CAVH) ) or continuous veno-venous hemodialysis (CVVHD).

Classification

Depending on the sodium content and thus the osmolality of the blood and extracellular fluids, hyperhydration is divided:

  • Hypotonic hyperhydration: the osmolality (i.e. essentially the sodium content) of the blood is reduced ( hyponatremia ).
  • Isotonic hyperhydration: the osmolality of the blood is normal.
  • Hypertonic hyperhydration: the osmolality of the blood is increased.

Hypotonic overhydration ("water poisoning")

This disease usually occurs when the loss of salts and fluids in hot weather, great exertion, vomiting or diarrhea is replaced with fluids that are low in salt (drinking water , infusions of glucose solutions ). An overhydration of the human organism sometimes also occurs with the consumption of MDMA (the main active ingredient in 'Ecstacy' ), since many users often consume a high amount of water for multifactorial reasons. Women in particular are considered to be at risk.

Symptoms of the disease are dizziness , headache, nausea, and vomiting ; In extreme cases, water poisoning in combination with a sodium deficiency can lead to organ damage and be fatal. The low sodium levels can lead to disorientation and serious brain dysfunction ( brain edema , tremor , ataxia , epileptiform muscle spasms, coma).

In the short term, healthy people can tolerate larger amounts of water without damage and without significant electrolyte shifts. Even the often accused distilled water is harmless to the body in normal quantities.

Individual evidence

  1. ↑ Amitava Majumder, Anne Paschen: Medical working techniques. In: Jörg Braun, Roland Preuss (Ed.): Clinic Guide Intensive Care Medicine. 9th edition. Elsevier, Munich 2016, ISBN 978-3-437-23763-8 , pp. 29-93, here: pp. 62-66 ( dialysis method ).
  2. ↑ Christian Spiller: Too much water can be deadly . - Interview on zeit.de from July 9, 2015.
  3. ↑ Hyponatremia - a great danger with MDMA consumption. In: FAZEmag -. September 27, 2018, accessed on November 8, 2019 (German).
  4. ↑ Ecstasy (MDMA): Warning, water poisoning - drinking too much can be fatal! In: clean on it! mindzone.info. June 25, 2018, accessed on November 8, 2019 (German).
  5. ^ Johanna Bayer: When drinking is fatal . From the SWR television broadcast on water poisoning on September 17, 2009 at 10:00 p.m.
  6. ↑ Joachim Frey : Diseases of the kidneys, the water and salt balance, the urinary tract and the male sexual organs. In: Ludwig Heilmeyer (ed.): Textbook of internal medicine. Springer-Verlag, Berlin / Göttingen / Heidelberg 1955; 2nd edition ibid. 1961, pp. 893–996, here: p. 907 (on water poisoning).
  7. ↑ TD Noakes, G. Wilson et al .: Peak rates of diuresis in healthy humans during oral fluid overload. In: South African medical journal. (S Afr Med J) October 2001, Vol. 91, No. 10, pp. 852-7, PMID 11732457 .
  8. ↑ Ask your professor: To what extent is distilled water toxic to humans because of the lack of electrolytes? How much distilled water can be drunk at once without causing any damage? Reply to klinphys.charite.de ; last accessed on March 11, 2016.