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Kahn¹ reports a sad but elucidating series of 7 patients with hypernatremia and edema. In my view, Kahn has performed a considerable service with this insightful report. The patients were for the most part elderly, critically ill, and had a host of concomitant medical problems. Notable is the weight gain observed in these patients, 5 of whom died in the hospital, from a weight of 85 to more than 110 kg; 110 to more than 132 kg; 83 to more than 109 kg; 111 kg with "weeping edema; " 77 to more than 106 kg; 54 to more than 62 kg; and 56 to more than 68 kg. Kahn points out that this weight gain consisted of an expansion in the extracellular fluid (ECF) volume. The ECF in young, healthy, 70-kg persons is about 13 L. The mean weight gain and ECF gain in these patients was about 20 kg . . . [Full Text of this Article]

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