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diagnosis management differential pharmacology nephrology algorithm treatment table hyponatremia causes medications clinical cardiology pathophysiology comparison hyperkalemia classification potassium rheumatology pocus
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid ADH promotes Urea/uric acid excretion along with water
Utilizing Uric Acid ADH ... Osmolarity 3) Urine Sodium ... Algorithm #nephrology #sodium
Hyponatremia (<135 mEq/L) is a common electrolyte abnormality caused by an excess of total body water
the total body sodium ... osmolality, urine sodium ... there is reduced sodium ... results in increased sodium ... Measured urine sodium
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
Ineffective (UNa >30) • ADH ... : SIADH, Renal Sodium ... Salt Wasting • ADH ... intake, UNa <20) • ADH ... diagnosis #table #sodium
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Hyponatremia: • ADH ... salt wasting • ADH ... Algorithm #diagnosis #sodium
Cerebral Salt Wasting vs SIADH - Pathophysiology 1) Neurological event 2) Sodium loss from tubules 3) Naturiesis →
Neurological event 2) Sodium ... Hypovolaemia → ADH
Hyponatremia - Differential Diagnosis Algorithm Hypovolemic - Give volume Hypervolemic (Edematous) - Look for and treat underlying cause
• UOsm > 300 - ADH ... - Appropriate ADH ... diagnosis #nephrology #sodium
Visualizing Hypotonic Hyponatremia • UNa reveals RAAS activity. • UOsm reveals ADH activity. • ADH secretion
• UOsm reveals ADH ... • ADH secretion ... nephrology #diagnosis #sodium
Hyponatremia - Differential Diagnosis by Mechanism Decr Blood Pressure (“Decr Effective Circulating Volume”) - Volume depletion
Inappropriate ADH ... insufficiency ADH ... Table #Causes #Sodium
Etiologies of Hypernatremia - Differential Diagnosis GI losses / Insensible losses Sodium Overload Transcellular Movement of Water Central Diabetes Insipidus
Insensible losses Sodium ... Insipidus (Decr ADH ... Insipidus (Incr ADH
Hyponatremia Diagnostic Algorithm 1) Check serum osmolality 2) Check urine osmolality 3) ADH Dependent - Check volume status, urine
osmolality 3) ADH ... status, urine sodium
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