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diagnosis hyponatremia nephrology differential algorithm management causes sodium table pharmacology treatment pathophysiology chf comparison diuretics signs symptoms cancer endocrinology low
Diabetes Insipidus vs Syndrome of Inappropriate ADH (SIADH) - Comparison Table Diabetes Insipidus - Inadequate ADH SIADH -
Inappropriate ADH ... (SIADH) - Comparison ... SIADH - Excess ... ADH #Diabetes ... #Insipidus #SIADH
Cerebral Salt Wasting vs SIADH - Pathophysiology 1) Neurological event 2) Sodium loss from tubules 3) Naturiesis →
Salt Wasting vs SIADH ... Hypovolaemia → ADH ... #SaltWasting #SIADH
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
restriction alone in SIADH ... Ineffective (UNa >30) • ADH ... Present (Uosm ≥100): SIADH ... Salt Wasting • ADH ... intake, UNa <20) • ADH
Urine Specific Gravity - Interpretation Specific Gravity = Density of urine / Density of water SG close to
resistance to ADH ... Dehydration • SIADH ... inappropriate ADH
Hyponatremia - Differential Diagnosis Algorithm ADH Independent: • Tea and Toast Syndrome, Beer Potomania - Low solute
Diagnosis Algorithm ADH ... ADH Dependent: ... insufficiency, SIADH
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Hyponatremia: • ADH ... OFF (UNa > 30): SIADH ... salt wasting • ADH
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid ADH promotes Urea/uric acid excretion along with water
Utilizing Uric Acid ADH ... Low Uric Acid → SIADH
Hyponatremia - Differential Diagnosis Algorithm Hypovolemic - Give volume Hypervolemic (Edematous) - Look for and treat underlying cause
• UOsm > 300 - ADH ... - Appropriate ADH ... , SSRIs) - SIADH
Hyponatremia - Differential Diagnosis by Mechanism Decr Blood Pressure (“Decr Effective Circulating Volume”) - Volume depletion
Inappropriate ADH ... secretion (SIADH ... insufficiency ADH
Hyponatremia Treatment Algorithm CHF, Cirrhosis - Fluid restriction SIADH - Fluid restriction - Consider salt tablets if etiology
Fluid restriction SIADH ... status turns off ADH
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