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diagnosis differential hyponatremia causes hypernatremia syndrome alkalosis cardiorenal chloride gitelman hypokalemia hypotonic management mechanisms metabolic physiologic urinary urine workup
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... : SIADH, Renal Sodium ... can be high or low ... differential #diagnosis #table ... #sodium #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... • Euvolemic (Low ... • Hypovolemic: Diuretics ... osmotic (solute) diuresis ... #nephrology #sodium
Mechanisms of nephron damage in cardiorenal syndrome • Increased renal interstitial pressure • Hypoperfusion • Reduced
Reduced renal blood flow ... hypertrophy • Sodium ... activities • Diuretic ... syndrome #Mechanisms #pathophysiology ... #nephrology
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Modified Hyponatremia Algorithm ... , Medications (diuretics ... Primary polydipsia, Low ... #diagnosis #sodium ... #nephrology
Causes of Hypernatremia - Differential Diagnosis Algorithm Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L High
Differential Diagnosis Algorithm ... water loss, Serum Sodium ... administration • Osmotic diuresis ... mannitol, glucosuria Low ... Hypernatremia #Nephrology
Metabolic Alkalosis - Urinary Chloride Algorithm Cl- responsive metabolic alkalosis • Kidney loss of Cl-
Urinary Chloride Algorithm ... loop or thiazide diuretics ... alkalosis • Normal/low ... pressure: Active diuretic ... #nephrology #differential
Hyponatremia - Differential Algorithm Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP Hypotonic Hyponatremia: • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
- Differential Algorithm ... • Hypovolemia: Diuretics ... #Differential #Algorithm ... diagnosis #causes #nephrology ... #sodium #low
Gitelman Syndrome Overview What? • Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter • Gitelman's syndrome
thiazide-sensitive sodium ... thiazide-sensitive sodium ... alkalosis • Normal or low ... Syndrome #diagnosis #nephrology ... #management #pathophysiology
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