Hyperhydration is an increased storage of total water in the organism. The cause may be short-term life conditions or chronic diseases. Medical intervention is required for any form of hyperhydration.
What is hyperhydration?
Hyperhydration is excessive infiltration of water into the body. Physicians distinguish 3 forms of pathological excess water. The basis of the classification is the distribution of sodium concentration within the different fluid fractions in the organism. Sodium is a dissolved component of common salt in the body and plays a major role in osmoregulation. This refers to the control of the body’s water and mineral balance (electrolyte balance). The physician speaks of isotonic hyperhydration when a supernormal increase of water and sodium occurs equally in all volumes. In this case, the concentration of water and sodium remains constant in the blood as well as in the cells and tissue fluid. Hypertonic hydration is characterized by excessive concentration of sodium in the blood. If the amount of sodium and water in the blood is too low, it is hypotonic hyperhydration. Notwithstanding the leading symptoms, excess fluid is a feature of all 3 forms of hyperhydration.
Causes
Hyperhydration often has serious causes. For example, cardiac insufficiency (heart failure) often results in failure to achieve the necessary filtration rate in the kidneys. As a result, the body excretes too little excess water and also sodium. Another underlying disease in hyperhydration can be liver cirrhosis. Both causes belong to the isotonic form of hyperhydration. Hypotonic hyperhydration often occurs in acute or chronic renal failure. The kidneys can no longer perform their function of maintaining a constant internal milieu. A less common cause is excessive intake of low-salt fluids. This includes, for example, gastric lavage in cases of poisoning. An over-supply of salt leads to hypertonic hyperhydration. It can also be referred to as salt poisoning. This rarely occurs when, for example, seawater was used to quench thirst or when consumption of other oversalted fluids leads to hyperhydration.
Symptoms, complaints, and signs
Depending on its form, hyperhydration can cause a variety of symptoms and complaints. Isotonic hyperhydration is primarily manifested by renal symptoms and circulatory symptoms. Those affected suffer, among other things, from dysfunctions of the internal organs and usually experience an increasing feeling of illness. Due to the impaired kidney function, weight gain and digestive problems occur. The isotonic form is associated with impaired physical and mental performance. The hypertonic hyperhydration causes similar complaints. Patients suffer from kidney pain, a severe malaise and other non-specific symptoms. The symptoms usually appear suddenly and persist for several weeks to months. If no treatment is given, hypertonic hyperhydration can develop into a chronic disease. The same applies to hypotonic hyperhydration, which can manifest itself with symptoms such as headaches, nausea and vomiting, and seizures. In addition, disorders of consciousness such as dizziness and visual disturbances are common. Due to the increased intracranial pressure, a severe malaise sets in, often accompanied by attacks of pain. In a severe course, the patient loses consciousness and finally falls into a coma. The individual forms of hyperhydration have in common that they occur in conjunction with an infusion and rapidly increase in intensity as they progress.
Diagnosis and course
The physician recognizes hyperhydration in both the hypertonic and hypotonic forms by blood laboratory values. The sodium level is then increased or decreased, respectively. The patient is helped quickly and without complications if there is only a short-term oversupply or undersupply of table salt or low-mineral water. This is due to current life circumstances. Chronic kidney failure in hypotonic hyperhydration practically means organ loss with far-reaching consequences. Isotonic hyperhydration usually results in the formation of edema. In this process, water leaks from the blood vessels into the interstitial spaces between tissues. Macroscopically visible signs may be swollen hands or feet.Life-threatening is pulmonary edema, which is detected by listening to the lungs because it is noticeable by rales when breathing. To confirm the diagnosis, the physician may order an X-ray examination. In the course of serious underlying diseases such as heart failure or liver cirrhosis, death is often the result of isotonic hyperhydration.
Complications
Hyperhydration causes a variety of symptoms and complaints that can lead to complications. First and foremost, the affected person suffers from relatively severe weight gain. This may occur at first without any particular reason. The patient suffers from fatigue and tiredness. The ability to cope with stress decreases and the affected person withdraws from life. In most cases, there is also palpitations and shortness of breath. It is not uncommon for breathing difficulties to lead to panic attacks and thus to a loss of consciousness. The affected person is confused and coordination disorders and concentration problems occur. The quality of life is considerably reduced by hyperhydration, so that normal everyday life is no longer possible for the patient without further ado. In the worst case, convulsions and epileptic seizures occur, during which the affected person suffers from extreme pain. Since hyperhydration occurs acutely in most cases, it can be treated relatively quickly. This does not lead to further complications. However, these can occur if hyperhydration is triggered by kidney failure. In this case, a donor kidney or dialysis is necessary for the patient. Furthermore, cardiac problems may also develop, so that in the worst case the patient may die of sudden cardiac death.
When should you go to the doctor?
If water retention or weight gain is noticed, hyperhydration may be underlying. A visit to the doctor is indicated if symptoms are associated with fatigue or seizures. Individuals who feel ill and exhausted for no reason should speak with their primary care physician immediately. Other alarm signs that require immediate evaluation are shortness of breath, rapid heartbeat and confusion. If panic attacks should be added, the affected person must be taken to a hospital. Hyperhydration cannot usually be recognized by the affected person himself, which is why unusual symptoms must be clarified medically in any case. Serious complications can often be prevented by early examination. However, if the excess water remains untreated, it can lead to secondary symptoms such as circulatory collapse and kidney failure. Individuals suffering from renal insufficiency are particularly susceptible to hyperhydration. There is also an increased risk of excess water in the body as a result of heart failure or cirrhosis of the liver. Anyone who belongs to these risk groups should have said signs and symptoms clarified quickly.
Treatment and therapy
Hyperhydration as an acute crisis is quickly resolved. Administration of electrolytes, i.e. fluids with appropriate and beneficial mineral content, is already sufficient. If acute or chronic renal failure is present in the context of hypotonic hyperhydration, the patient initially requires dialysis (“blood washing”). In case of complete functional failure of the kidney, transplantation is attempted. The administration of diuretic drugs is the physician’s first measure if edema has formed in the course of isotonic hyperhydration. Fluid balancing provides information about water status. Often, the patient is instructed to consume only a small amount of fluid; furthermore, the underlying disease must be addressed. Heart failure requires heart-strengthening medications (“digitalis”). If severe arrhythmias occur, the surgeon must implant a pacemaker. Ultima ratio in severe cases is a heart transplant. Cirrhosis of the liver is not treatable causally. Some relief may be provided by an appropriate low-fat diet. Degenerating liver disease is certainly one of the worst causes of hyperhydration.
Outlook and prognosis
The general health condition gradually deteriorates in hyperhydration if medical treatment is not sought. Although it usually does not result in a life-threatening condition, the quality of life is significantly reduced.This can lead to mental stress and ultimately to psychological secondary diseases. An improvement of the symptoms is only possible if the cause of the water retention is found and treated. In the case of a chronic underlying disease, symptomatic therapy is usually carried out. There is no cure for these patients. The medical options are intended to slow down the progress of the underlying disease and, if necessary, to prolong the patient’s life expectancy. Therapy is aimed at enhancing well-being, since a cure is not possible with current scientific approaches. An acute situation is managed with intensive care. Complete relief of hyperhydration occurs after a short time. Nevertheless, the overall diagnosis must be considered to allow a complete prognosis and to prevent a rapid recurrence of hyperhydration. If the patient suffers from cardiac rhythm disturbances, he needs extensive further medical care. If renal failure is present, organ failure may occur, resulting in sudden death of the patient. In most underlying diseases, action is needed to ensure that the patient is permanently free of symptoms of hyperhydration.
Prevention
Hyperhydration presents itself in prophylaxis as adherence to general healthy lifestyle advice. For example, extreme over-salting is to be avoided, especially in midsummer “reasonable” drinks, for example, low-sodium mineral water or the like should be drunk. Refraining from stimulant abusiveness, instead plenty of exercise in fresh air are ultimately also a prevention against hyperhydration.
Follow-up
In the case of hyperhydration, there are usually few measures of aftercare available to the affected person. First and foremost, there must be rapid and, above all, early recognition of this condition so that further complications can be prevented. As a rule, hyperhydration cannot be cured independently, so that medical treatment must always be carried out first. The earlier hyperhydration is detected, the better the further course of the disease usually is. The disease can often be treated relatively well and simply by taking a special solution. The affected person must pay attention to the correct dosage and regular intake in order to alleviate the symptoms. Recurring checks and examinations by a doctor are also very useful in order to monitor the status. Since hyperhydration can also have a negative effect on the heart of the affected person, the heart should also be monitored. At the same time, the affected person should not put unnecessary strain on his or her body or engage in strenuous activities. In some cases, therefore, sufferers also rely on the help and support of friends and their own family.
What you can do yourself
In many cases of hyperhydration, self-treatment is not possible, so sufferers must rely on medical intervention. First and foremost, if the condition is present, water intake should be reduced to prevent further accumulation if the water has been ingested in a large quantity. In acute emergencies, a physician must be notified who can administer an electrolyte solution to the affected person to balance the mineral balance. Taking diuretic medication can also have a positive effect on the disease and alleviate the symptoms. Furthermore, a healthy lifestyle with a healthy diet also has a very positive effect on the course of hyperhydration. In case of a chronic course, however, treatment by a physician is inevitable and cannot be replaced by self-help. If the affected person suffers from shortness of breath or loss of consciousness, an emergency physician must be notified or the hospital must be visited. Until the emergency physician arrives, the affected person must receive emergency ventilation and be placed in a stable lateral position. In the event of salt poisoning, the affected person must drink low-salt water to restore the body’s salt balance.
