23 results
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
Physiologic Approach ... time you have a case ... normal volume-based algorithm ... Hypothyroidism, Adrenal ... #nephrology
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
Differential Algorithm ... low, uric acid ... high in hypovolemic ... and uric acid low ... #Diagnosis #Nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Volume Based Approach ... to Hyponatremia ... Hypovolemic, Serum ... #algorithm #diagnosis ... #sodium #low #nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... ON (UNa < 30): Hypovolemia ... Hypothyroidism, Adrenal ... Primary polydipsia, Low ... #sodium #nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... HYPOVOLEMIC • ... Diagnosis #Workup #Algorithm ... #Nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... Differential Diagnosis Algorithm ... Cardiac failure #Hyponatremia ... Differential #Diagnosis #Algorithm ... #Causes #nephrology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... Beer Potomania - Low ... Dependent: • Hypovolemic ... #causes #nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... Syndrome, Chronic Renal ... #diagnosis #causes ... #nephrology #sodium ... #low
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Algorithm UOsm ... EABV) - Consider: Hypovolemia ... Primary polydipsia, Low ... solute intake, Renal ... #causes #nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... High Uric Acid → renal ... #nephrology #sodium ... #low #uricacid