11 results
Algorithm for Differentiating Gitelman syndrome from Bartter syndrome
 • Urine Chloride
 • Urine Ca/Cr ratio

Dr. Krithika
Gitelman syndrome ... syndrome • Urine Chloride ... • Urine Ca/Cr ... #nephrology #hypokalemia ... #diagnosis
Gitelman Syndrome Pathophysiology
Gitelman Syndrome is a rare autosomal recessive salt-losing tubulopathy with a prevalence of 1-
thiazide-sensitive sodium-chloride ... in the distal tubule ... Contraction → ↑ Renin ↑ Ca ... Pathophysiology #nephrology ... #diagnosis
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Serum Osmolarity 2) ... Osmolarity 3) Urine Sodium ... #Algorithm #nephrology
Hypernatremia Differential Diagnosis Algorithm - Diabetes Insipidus Workup

Step #1 - Consider the history
Step #2 - Assess
Hypernatremia Differential ... Diagnosis Algorithm ... history Step #2 ... #Management #Algorithm ... #Sodium #nephrology
Metabolic Alkalosis - Urinary Chloride Algorithm
Cl- responsive metabolic alkalosis
 • Kidney loss of Cl-
Algorithm Cl- ... Bartter syndrome, Gitelman ... #urine #Algorithm ... #nephrology #differential ... #diagnosis
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... Step 2. ... #Diagnosis #Workup ... #Algorithm #Nephrology
Inherited Defects in Kidney Tubule Epithelial Cells

Renal glucosuria - Na+-dependent glucose cotransporter
Cystinuria - Amino acid transporter
Bartter
ascending limb Gitelman ... cell epithelial sodium ... of epithelial sodium ... Defects #Kidney #Nephrology ... #Diagnosis #Differential
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis ... Workup Algorithm ... renal mechanism 2) ... #Workup #Algorithm ... #nephrology #sodium
Gitelman Syndrome Overview

What?
• Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter
• Gitelman's syndrome
thiazide-sensitive sodium ... thiazide-sensitive sodium ... distal convoluted tubule ... #Syndrome #diagnosis ... #nephrology #management
Hyponatremia Diagnostic Algorithm
1) Check serum osmolality
2) Check urine osmolality
3) ADH Dependent - Check volume status, urine
Hyponatremia Diagnostic ... serum osmolality 2) ... status, urine sodium ... #Diagnosis #Algorithm ... #nephrology