17 results
Hypernatremia Differential Diagnosis Algorithm - Diabetes Insipidus Workup

Step #1 - Consider the history
Step #2 - Assess
Hypernatremia Differential ... Diagnosis Algorithm - Diabetes ... Eric Strong @DrEricStrong ... Management #Algorithm #Sodium ... #nephrology #insipidus
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Hypernatremia - Differential ... insipidus • Nephrogenic ... diabetes insipidus ... Diagnosis #Causes #nephrology ... #sodium #high
Polyuria - Differential Diagnosis Algorithm
Urine Output > 3L /day
Water Diuresis (Urine Osm <100 mOsm/kg)
 • Primary
Polyuria - Differential ... Insipidus • Nephrogenic ... Diabetes Insipidus ... solute loading • Relief ... Algorithm #causes #nephrology
Urine Specific Gravity - Interpretation
Specific Gravity = Density of urine / Density of water
SG close to
Excessive hydration • Diabetes ... insipidus (deficiency ... Dehydration • SIADH (syndrome ... Interpretation #diagnosis #differential ... #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - Differential ... • Euvolemic: Diabetes ... insipidus (central ... Workup #Algorithm #nephrology ... #sodium
Inherited Defects in Kidney Tubule Epithelial Cells

Renal glucosuria - Na+-dependent glucose cotransporter
Cystinuria - Amino acid transporter
Bartter
of epithelial sodium ... ATPase Nephrogenic diabetes ... insipidus - Vasopressin ... Defects #Kidney #Nephrology ... #Diagnosis #Differential
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Hypernatremia - Differential ... water loss, Serum Sodium ... 300 mmol/kg • Diabetes ... Insipidus Hypodipsia ... Hypernatremia #Nephrology
Diabetes Insipidus - Diagnosis Algorithm
Tests:
 • Osmolality, Urine AND/OR
 • Osmolality, Serum or Plasma AND
 •
Diabetes Insipidus ... Plasma AND • Sodium ... #Insipidus #Diagnosis ... #Algorithm #nephrology ... #differential
Causes of Polyuria - Differential Diagnosis
Excess Intake of Water:
 • Primary polydipsia (a.k.a. "psychogenic polydipsia")
 •
of Polyuria - Differential ... Poorly controlled diabetes ... Diabetes Insipidus ... - Strong Medicine ... Diagnosis #Causes #nephrology
Causes of Fatigue - Differential Diagnosis Algorithm
Endocrine
 • Hypo/Hyperthyroidism
 • Diabetes
 • Pituitary Insufficiency
 • Adrenal
Hyperthyroidism • Diabetes ... Pulmonary Disease Neurologic ... Sclerosis • Stroke ... Myasthenia Gravis Pharmacologic ... Chronic Fatigue Syndrome