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Diagnosis and Management of Hypernatremia

#Hypernatremia #Differential #Algorithm #Causes #Nephrology #Diagnosis

** GrepMed Recommended Text: Nephrology Secrets -
Management of Hypernatremia ... #Hypernatremia ... #Differential #Algorithm ... #Causes #Nephrology ... Recommended Text: Nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... mmol/L - true hyponatremia ... failure #Hypernatremia ... Diagnosis #Workup #Algorithm ... #Nephrology
Hypernatremia Management Algorithm
Acute vs Chronic
Calculate Losses
 • Current water Deficit
 • Ongoing Free water Losses
 •
Hypernatremia Management ... Algorithm Acute ... Medicine @SCVMCMed #Hypernatremia ... #Management #Algorithm ... #treatment #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... Differential Diagnosis Algorithm ... UNa > 20: • Acute ... Cardiac failure #Hyponatremia ... #Causes #nephrology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... solute intake, Renal ... @NephroMD #hyponatremia ... #causes #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Pain/Post-op • Neurologic ... GI losses • Renal ... osmole intake #Hyponatremia ... #Nephrology #Differential
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Pain/Post-op • Neurologic ... GI losses • Renal ... osmole intake #Hyponatremia ... #Nephrology #Differential
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... • Renal Failure ... thecurbsiders #Hyponatremia ... #causes #nephrology
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... perspiration Renal ... administration #Hypernatremia ... Differential #Diagnosis #Causes ... #nephrology #sodium
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... Extrarenal Hypernatremia ... Hypernatremia: ... MatthewHoMD #Hypernatremia ... #nephrology #sodium