Safety and Efficacy of Hydrochlorothiazide in the Treatment of Hypernatremia in Critically Ill Patients

Inclusion Criteria: * hospitalized for intensive care, * Over 18 years of age, * Two serum sodium measurements above 145 mEq / L (with no pre-determined interval between them), * Mean arterial pressure greater than 65mmHg Exclusion Criteria: * Absence of consent to participate in the study * Cardiac index below 2.5L / min / m2 OR signs of ineffective circulation (capillary filling time greater than 2 seconds, cold or sticky skin) OR arterial lactate\> 4mMol / L. * Use of vasopressors at doses greater than 0.1 mcg / kg / min of noradrenaline or with initiation or increase of dose within less than one hour before inclusion in the study. * Unavailable enteral route. * Use of hydrochlorothiazide in the last 7 days of ICU admission. * History of allergy or intolerance to hydrochlorothiazide or other thiazides. * Nephrogenic Diabetes Insipidus. * Renal impairment KDIGO 3 * Indication of renal replacement therapy. * Acute neurological insult. * Heart failure American Heart Association classification (AHA), class D. * Liver cirrhosis Child-Pugh C. * Pregnant women * Exclusive palliative care * Dying, with expected survival less than 48 hours