12 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
and Workup Step ... Repeat the sodium ... liver failure • nephrotic ... syndrome • renal ... #Algorithm #Nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... failure, Cirrhosis, Nephrotic ... syndrome - ... Primary polydipsia, Low ... #sodium #nephrology
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 ... failure, Cirrhosis, Nephrotic ... syndrome) • ADH ... #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Hypothyroidism, Low ... failure, Cirrhosis, Nephrotic ... syndrome • Urine ... #algorithm #diagnosis ... #sodium #low #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis Workup ... Algorithm 1) ... • Euvolemic (Low ... #Algorithm #nephrology ... #sodium
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Syndrome of Inappropriate ... Cirrhosis • Nephrotic ... GFR, AKI/CRF Hormonal ... #Nephrology #Differential
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Syndrome of Inappropriate ... Cirrhosis • Nephrotic ... GFR, AKI/CRF Hormonal ... #Nephrology #Differential
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Diagnosis Algorithm ... Beer Potomania - Low ... liver failure, nephrotic ... syndrome ... #causes #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... CHF, cirrhosis, nephrotic ... syndrome) Euvolemic ... #diagnosis #nephrology ... #sodium
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... Liver Cirrhosis, Nephrotic ... Syndrome, Chronic ... diagnosis #causes #nephrology ... #sodium #low