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—In reply to Dr Matz, we concur that the formula given for use in patients with uncontrolled diabetes and diabetic hyperglycemia may result in a more accurate estimate of FWD. We also agree that severe hyperlipidemia can present as pseudohyponatremia if the serum sodium is measured without correcting for the presence of hypertriglyceridemia or chylomicronemia. It is clear, however, that the vast majority of cases of hypernatremic dehydration in the elderly can be diagnosed without difficulty if proper awareness to this potential problem is manifested by the clinician.The comments by Drs Warren and Harris and Ms Phillips correctly point out the important fact that dehydration remains a problem among both institutionalized and community-dwelling elderly. We also agree that community-based awareness programs for educating the public hopefully could help to reduce the number of cases reported in the community setting. Last, we concur that infection is the major
Weinberg AD, Allen JR. Dehydration in Older Adults-Reply. JAMA. 1996;275(12):912. doi:10.1001/jama.1996.03530360021032