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differential algorithm management causes hypokalemia sodium hypernatremia syndrome workup table urine alkalosis anticoagulation barre chloride citrate criteria criticalcare diuretics excretion
Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA
Hypernatremia Diagnosis ... NORMAL PLASMA OSMOLALITY ... volume loss - diuretics ... HYPERVOLEMIC • CHF • liver ... #Algorithm #Nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis ... • Euvolemic (Low ... • Hypovolemic: Diuretics ... osmotic (solute) diuresis ... Workup #Algorithm #nephrology
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
remember than the normal ... can be high or low ... Primary polydipsia), Low ... #differential #diagnosis ... table #sodium #nephrology
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Modified Hyponatremia ... , Medications (diuretics ... Primary polydipsia, Low ... #Algorithm #diagnosis ... #sodium #nephrology
Diuretics and Agents Regulating Renal Excretion Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide) • Glaucoma • Epilepsy • Altitude
disequilibrium syndrome • Diagnosis ... nephrotic syndrome • Hyponatremia ... Tolvaptan) • Treatment ... and euvolemic hyponatremia ... #Nephrology #Pharmacology
Hypokalemia - Differential Diagnosis Algorithm Extra-renal Losses: • Normal Acid-Base: Low intake • Metabolic acidosis: Gl tract
- Differential Diagnosis ... Extra-renal Losses: • Normal ... Loop and thiazide diuretics ... Algorithm #causes #potassium ... #low #nephrology
Hypokalemia Differential Diagnosis Algorithm Hypertensive: • High Al, Low R - Primary aldosteronism • High Al, High
Hypokalemia Differential Diagnosis ... >20 mEq/24 h - Diuretics ... #Differential #Diagnosis ... #Algorithm #nephrology ... #causes #low #potassium
Hyponatremia - Differential Diagnosis Algorithm ADH Independent: • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... Beer Potomania - Low ... Heart failure, liver ... Algorithm #causes #nephrology
Hypokalemia - Differential Diagnosis Algorithm Transcellular Shift: • Alkalosis • ↑ beta-2 adrenergic simulation • Erythropoiesis
- Differential Diagnosis ... vomiting) • Low ... • Discontinued diuretic ... #Algorithm #nephrology ... #low #potassium
Causes of Hypernatremia - Differential Diagnosis Algorithm Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L High
- Differential Diagnosis ... administration • Osmotic diuresis ... mannitol, glucosuria Low ... #Nephrology #Differential ... #Diagnosis #Algorithm
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