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AKI in Cirrhosis - Hepatorenal Syndrome Management Algorithm

DOI: 10.1136/bmj.m2687

#AKI #Cirrhosis #Hepatorenal #Syndrome #HRS #Management #Algorithm #nephrology
AKI in Cirrhosis ... - Hepatorenal Syndrome ... Management Algorithm ... #Hepatorenal #Syndrome ... #Algorithm #nephrology
Hypokalemia - Differential Diagnosis Algorithm
Extra-renal Losses:
 • Normal Acid-Base: Low intake
 • Metabolic acidosis: Gl tract
Hypokalemia - Differential ... Normal Acid-Base: Low ... Carbenoxolone, SAME, Cushing ... @priti899 #Hypokalemia ... #nephrology
Algorithm for patients with hypokalemia on the basis of the potassium-to-creatinine ratio in the urine
Urine K+
patients with hypokalemia ... • Cell shift: Hypokalemic ... ↓ Aldosterone: Cushing ... #hypokalemia ... algorithm #diagnosis #nephrology
Hepatorenal Syndrome Diagnosis
 • ↑ in serum Cr of ≥ 0.3mg/dL above baseline
Hepatorenal Syndrome ... (e.g. advanced cirrhosis ... type 2 HRS) • Low ... #Syndrome #diagnosis ... #HRS #nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
ON (UNa < 30): Hypovolemia ... Heart failure, Cirrhosis ... , Nephrotic syndrome ... Primary polydipsia, Low ... diagnosis #sodium #nephrology
Hyperkalemia - Diagnosis and Management - GrepMed Handbook

S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
and Management ... Weakness, cramping ... delivery): CHF, cirrhosis ... acidosis) • Low ... Treatment #potassium #nephrology
Gitelman Syndrome Overview

What?
• Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter
• Gitelman's syndrome
Inherited (AR) hypokalemic ... abuse • Salt craving ... alkalosis • Normal or low ... #diagnosis #nephrology ... #management #pathophysiology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
can be high or low ... Present (Uosm ≥100): Hypovolemia ... Heart failure, Cirrhosis ... , Nephrotic syndrome ... table #sodium #nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Hyponatremia: • Hypovolemia ... Failure, Liver Cirrhosis ... , Nephrotic Syndrome ... diagnosis #causes #nephrology ... #sodium #low