37 results
Flowchart to diuretic use in acute heart failure.

(A) Congestion with volume overload. 

(B) Treatment algorithm after
(B) Treatment algorithm ... Total loop diuretic ... intravenous; SGLT2‐I, sodium–glucose ... following a single loop ... #CHF #Algorithm
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... concentrating defect: • Diuretics ... • Osmotic diuresis ... Differential #Diagnosis #Causes ... #nephrology #sodium
Hyponatremia Treatment Algorithm

CHF, Cirrhosis - Fluid restriction
SIADH - Fluid restriction
 - Consider salt tablets if etiology
Hyponatremia Treatment ... Algorithm CHF ... consider adding loop ... diuretic Reset ... -> free water diuresis
Diuretics - Pharmacology

Thiazides diuretics:
 • Inhibit Na+ Cl- cotransporter in distal tubule
 • Chlorothiazide, Chlorthalidone, Indapamide,
Metolazone Loop ... as no effect on sodium ... Pharmacology #nephrology #conversion ... #loop #thiazide ... #classes
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic ... , Medications (diuretics ... #Algorithm #diagnosis ... #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 ... volume loss - diuretics ... Diagnosis #Workup #Algorithm
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Causes of Hypernatremia ... Differential Diagnosis Algorithm ... water loss, Serum Sodium ... administration • Osmotic diuresis ... #Causes
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... • Hypovolemic: Diuretics ... osmotic (solute) diuresis ... Diagnosis #Workup #Algorithm ... #nephrology #sodium
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... Diagnosis Algorithm ... (Edematous) - Look ... treat underlying cause ... diagnosis #nephrology #sodium
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... normal volume-based algorithm ... : SIADH, Renal Sodium ... loss (diuretics ... diagnosis #table #sodium