55 results
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... can be high or low ... Losses (AKI, Post-AKI ... Cirrhosis, Nephrotic syndrome ... Primary polydipsia), Low
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Differential Diagnosis Algorithm ... Syndrome of Inappropriate ... GI losses • Renal ... • Reduced GFR, AKI
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Differential Diagnosis Algorithm ... Syndrome of Inappropriate ... GI losses • Renal ... • Reduced GFR, AKI
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... • Euvolemic (Low ... Hypervolemic: Conn syndrome ... , Cushing syndrome ... Diagnosis #Workup #Algorithm
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... Tea and Toast Syndrome ... Beer Potomania - Low ... failure, nephrotic syndrome
Hypokalemia - Differential Diagnosis Algorithm
Extra-renal Losses:
 • Normal Acid-Base: Low intake
 • Metabolic acidosis: Gl tract
Differential Diagnosis Algorithm ... Normal Acid-Base: Low ... Ureterosigmoidoscopy • HTN, Low ... Differential #Diagnosis #Algorithm ... causes #potassium #low
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Hypothyroidism, Low ... Cirrhosis, Nephrotic syndrome ... #algorithm #diagnosis ... #sodium #low #nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... mmol/L - true hyponatremia ... • nephrotic syndrome ... #Hypernatremia ... Diagnosis #Workup #Algorithm
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Uric Acid - Low ... High Uric Acid → renal ... nephrology #sodium #low
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic ... Cirrhosis, Nephrotic syndrome ... Primary polydipsia, Low ... #Algorithm #diagnosis