Rate of correction of hypernatremia

depends on acuity of onset and risk:

chronic (>48 hr): ~12 mEq/d appears safe w/o risk of cerebral edema (CJASN 2019;14:656)

acute (<48 hr): may ↓ Na by 2 mEq/L/h until Na 145

hyperacute (min-hrs) & life threatening (ICH, seizure): rapidly infuse D5W ± emergent HD