13 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 ... , Renal Sodium loss ... Hypothyroidism, Adrenal
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Volume Based Approach ... Hypovolemic, Serum ... uric acid <4 • SIADH ... #algorithm #diagnosis ... #sodium #low #nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
ON (UNa < 30): Hypovolemia ... OFF (UNa > 30): SIADH ... Hypothyroidism, Adrenal ... Primary polydipsia, Low ... #sodium #nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Repeat the sodium ... HYPOVOLEMIC • ... EUVOLEMIC • SIADH ... hypothyroidism • adrenal ... Diagnosis #Workup #Algorithm
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Diagnosis Algorithm ... Beer Potomania - Low ... Dependent: • Hypovolemic ... insufficiency, SIADH ... #causes #nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... • Euvolemia: SIADH ... #diagnosis #causes ... #nephrology #sodium ... #low
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
EABV) - Consider: Hypovolemia ... Inappropriate - Consider: SIADH ... 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 ... Uric Acid → SIADH ... High Uric Acid → renal ... #low #uricacid
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... Hypovolemic - Give ... treat underlying cause ... , SSRIs) - SIADH ... diagnosis #nephrology #sodium
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... : • Hypovolemic ... • Euvolemic (Low ... • Hypovolemic: ... #nephrology #sodium