11 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
and Workup Step ... Repeat the sodium ... HYPOVOLEMIC • ... EUVOLEMIC • SIADH ... #Algorithm #Nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... 2) Urine Osmolarity ... 3) Urine Sodium ... Uric Acid → SIADH
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Algorithm 1) ... Check Urine Osmolality ... : • Hypovolemic ... • Euvolemic (Low ... #sodium
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
Differential Algorithm ... sodium low, uric ... acid high in hypovolemic ... - Urine sodium ... and uric acid low
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Hypovolemic, Serum ... uric acid <4 • SIADH ... Hypothyroidism, Low ... #algorithm #diagnosis ... #sodium #low #nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... ON (UNa < 30): Hypovolemia ... OFF (UNa > 30): SIADH ... 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 ... Urine Na+K / serum ... , Renal Sodium loss ... can be high or low ... , Hypervolemia with
Hyponatremia (<135 mEq/L) is a common electrolyte abnormality caused by an excess of total body water
, urine sodium concentration ... and urine osmolality ... Measured urine sodium ... #RAAS #Hypovolemia ... EBV #potomania #SIADH
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Differential Diagnosis Algorithm ... water loss, Serum Sodium ... Osmolality > 300 ... mannitol, glucosuria Low ... Urine Osmolality
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... : • Hypovolemia ... • Euvolemia: SIADH ... causes #nephrology #sodium ... #low