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Algorithm for Management of SIADH with Fluid Restriction and Urea

by Helbert Rondon, MD @NephroMD

#SIADH #Management #algorithm
of SIADH with Fluid ... Management #algorithm #treatment ... #urea #nephrology
Hyperkalemia Treatment Options
Stabilize cardiac membrane:
 • IV Calcium (peaks 5-10 minutes)
Decrease potassium concentration:
 • IV Fluids
Shift
Hyperkalemia Treatment ... concentration: • IV Fluids ... management #potassium #nephrology
Hypernatremia - Differential Diagnosis and Treatment
Hypernatremia is almost always due to unreplaced water loss (free water
Diagnosis and Treatment ... : Treatment of ... with isotonic fluids ... delivered with D5 fluids ... #management #nephrology
Rhabdomyolysis - Differential Diagnosis Framework and Management Summary

Causes of Rhabdomyolysis:
 • Trauma:
	- Immobilization
	- Crush injury
	- Compartment
extracellular fluid ... Treatment of underlying ... azotemia: Isotonic fluid ... diuretics for fluid ... #nephrology
Methotrexate Renal Toxicity 
Prevention:
 • Alkalinize the urine, keep urine ph >7
 • Start pre-treatment 12
• Start pre-treatment ... 48 hours post Treatment ... bicarbonate based fluids ... Toxicity #management #treatment ... #nephrology
Classification of Diabetes Insipidus

Central or neurogenic diabetes insipidus:
 - Congenital - Structural malformations affecting the hypothalamus
characterized by excessive fluid ... Treatment is aimed ... Classification #Types #Nephrology
Hyponatremia Treatment Algorithm

CHF, Cirrhosis - Fluid restriction
SIADH - Fluid restriction
 - Consider salt tablets if etiology
Hyponatremia Treatment ... CHF, Cirrhosis - Fluid ... restriction SIADH - Fluid ... Reset Osmostat - Treatment ... #Hyponatremia #Treatment
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
briskly to IV fluids ... - Responds to fluid ... Failure - Restrict fluid ... Algorithm #causes #nephrology
Diuresis in Critical Care - Achieving a Negative Fluid Balance
Advantages Of A Negative Fluid Balance:
 •
Achieving a Negative Fluid ... Of A Negative Fluid ... Achieving a negative fluid ... liter of positive fluid ... Early nephrologv
Prescribing Maintenance IV Fluids
Assess
 • Can the patient meet their fluid needs orally or enterally? If
patient meet their fluid ... If so no IV fluid ... • Consider fluid ... , Examination, Fluid ... daily - Stop IV fluid