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Pathophysiology of hypotonic hyponatremia

by Helbert Rondon, MD @NephroMD

#hypotonic #hyponatremia #nephrology #algorithm #Pathophysiology
Pathophysiology ... of hypotonic hyponatremia ... #hyponatremia # ... nephrology #algorithm ... #Pathophysiology
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... water Extrarenal hypotonic ... perspiration Renal ... salt intake: • Hypertonic ... Diagnosis #Causes #nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic ... Urologic irrigants Hypotonic ... Primary polydipsia, Low ... diagnosis #sodium #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
Hyponatremia The ... can be high or low ... Primary polydipsia), Low ... differential #diagnosis #table ... #sodium #nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
, Recent TURP Hypotonic ... Syndrome, Chronic Renal ... Hypothyroidism Hypertonic ... diagnosis #causes #nephrology ... #sodium #low
Hyponatremia with Severe Symptoms - Management Algorithm with Hypertonic Saline
The goal of acute management is to
Hyponatremia with ... Algorithm with Hypertonic ... probably not the low ... kidney_boy #Hyponatremia ... #Saline #nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Uric Acid - Low ... High Uric Acid → renal ... Diagnosis #Algorithm #nephrology ... #sodium #low #uricacid
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Hypothyroidism, Low ... SatyaPatelMD #Volume #Hyponatremia ... diagnosis #sodium #low ... #nephrology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Primary polydipsia, Low ... solute intake, Renal ... @NephroMD #hyponatremia ... algorithm #causes #nephrology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Beer Potomania - Low ... • Renal Failure ... Hypovolemic - GI losses, renal ... Algorithm #causes #nephrology