35 results
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... concentrating defect: • Diuretics ... • Osmotic diuresis ... Differential #Diagnosis #Causes ... #nephrology #sodium
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Algorithm 1) Check Urine ... • Hypovolemic: Diuretics ... , Cushing syndrome ... Workup #Algorithm #nephrology ... #sodium
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Pain/Post-op • Neurologic ... especially thiazide diuretics ... Hypo-osmolar urine ... #Nephrology #Differential
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Pain/Post-op • Neurologic ... especially thiazide diuretics ... Hypo-osmolar urine ... #Nephrology #Differential
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Causes of Hypernatremia ... water loss, Serum Sodium ... 145 mmol/L High Urine ... administration • Osmotic diuresis ... #Nephrology #Differential
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... volume-based algorithm Urine ... : SIADH, Renal Sodium ... Cirrhosis, Nephrotic syndrome ... #nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... volume loss - diuretics ... • nephrotic syndrome ... Workup #Algorithm #Nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Cirrhosis, Nephrotic syndrome ... , Medications (diuretics ... Algorithm #diagnosis #sodium ... #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Cirrhosis, Nephrotic syndrome ... SatyaPatelMD #Volume #Hyponatremia ... algorithm #diagnosis #sodium ... #low #nephrology
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Neurological event 2) Sodium ... ) Naturiesis → diuresis ... → Increased urine ... Pathophysiology #diagnosis #nephrology ... #hyponatremia #