18 results
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
True Hyponatremia ... sodium low, uric ... and hypervolemic hyponatremia ... - Urine sodium ... in euvolemic hyponatremia
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Sodium 4) Serum ... Uric Acid → SIADH ... Rachel Stern MD #Hyponatremia
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Hypovolemic, Serum ... uric acid <4 • SIADH ... SatyaPatelMD #Volume #Hyponatremia ... #sodium #low #nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Hyponatremia: Hyperglycemia ... ON (UNa < 30): Hypovolemia ... OFF (UNa > 30): SIADH ... #sodium #nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... mmol/L - true hyponatremia ... HYPOVOLEMIC • ... renal failure #Hypernatremia
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Salt Wasting vs SIADH ... Neurological event 2) Sodium ... → Increased urine ... #SaltWasting #SIADH ... diagnosis #nephrology #hyponatremia
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
Approach to Hypotonic Hyponatremia ... case of hypotonic hyponatremia ... normal volume-based algorithm ... Urine Na+K / serum ... Physiologic #Hypotonic #Hyponatremia
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Hyponatremia - Differential ... Hyponatremia: Hyperlipidemia ... TURP Hypotonic Hyponatremia ... • Euvolemia: SIADH ... #low
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... EABV) - Consider: Hypovolemia ... Inappropriate - Consider: SIADH ... Primary polydipsia, Low ... @NephroMD #hyponatremia
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... Extrarenal Hypernatremia ... • Euvolemic (Low ... Ingestion Renal Hypernatremia ... MatthewHoMD #Hypernatremia