12 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
and Workup Step ... Repeat the sodium ... EUVOLEMIC • SIADH ... • nephrotic syndrome ... #Algorithm #Nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Cirrhosis, Nephrotic syndrome ... OFF (UNa > 30): SIADH ... Primary polydipsia, Low ... Algorithm #diagnosis #sodium ... #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
uric acid <4 • SIADH ... Hypothyroidism, Low ... Cirrhosis, Nephrotic syndrome ... algorithm #diagnosis #sodium ... #low #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
, Renal Sodium loss ... can be high or low ... Cirrhosis, Nephrotic syndrome ... differential #diagnosis #table ... #sodium #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis Workup ... • Euvolemic (Low ... , Cushing syndrome ... #Algorithm #nephrology ... #sodium
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Toast Syndrome, ... Beer Potomania - Low ... insufficiency, SIADH ... Algorithm #causes #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... cirrhosis, nephrotic syndrome ... , SSRIs) - SIADH ... Algorithm #diagnosis #nephrology ... #sodium
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Hyponatremia - Differential ... • Euvolemia: SIADH ... Cirrhosis, Nephrotic Syndrome ... diagnosis #causes #nephrology ... #sodium #low
Primary Polydipsia
Definition: Excessive volitional water intake
Epidemiology:
 • 6-20% of patients with psychiatric disorders - Most commonly
patients with psychiatric ... ADH suppression and ... Pseudohyponatremia, SIADH ... intoxication Initial Workup ... diagnosis #management #nephrology
Hypophosphatemia - Differential Diagnosis Algorithm
Appropriately Low Kidney Phosphate Excretion:
 • Decreased GI Absorption: Chronic Diarrhea, Antacids,
Appropriately Low ... Bisphosphonate and ... (MM, lymphoma, cancer ... Diagnosis #Algorithm #nephrology ... #phosphorus #workup