26 results
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
Sodium loss (diuretics ... can be high or low ... Primary polydipsia), Low ... differential #diagnosis #table ... #sodium #nephrology
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... perspiration Renal ... • Osmotic diuresis ... Diagnosis #Causes #nephrology ... #sodium #high
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
mOsm/kg - Implies renal ... • Euvolemic (Low ... , Ingestion Renal ... Workup #Algorithm #nephrology ... #sodium
Hypernatremia Classification and Features According to Volume Status
 - Hypervolemic hypernatremia - Cushing's syndrome, Primary hyperaldosteronism,
Hypodipsia - Renal ... - Osmotic diuretic ... , Loop diuretics ... Diagnosis #Comparison #Table ... #Nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... - fevers • renal ... volume loss - diuretics ... Workup #Algorithm #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
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... losses, Diuretic ... and metabolic alkalosis ... Ketonuria, Osmotic diuresis ... Algorithm #Causes #nephrology
Primary Metabolic Alkalosis - Differential Diagnosis Algorithm
Volume Depleted 2° hyperaldosteronism
 • Low Urine Cl-: Vomiting, NGT
Primary Metabolic Alkalosis ... Cl intake, Diuretics ... High Urine Cl-: Diuretics ... hyperaldosteronism • High PRA: Renal ... Diagnosis #Algorithm #nephrology
Primary Metabolic Alkalosis - Differential Diagnosis Algorithm
Volume Depleted - 2° hyperaldosteronism
 • Low Urine Cl-: Vomiting,
Primary Metabolic Alkalosis ... Cl intake, Diuretics ... High Urine Cl-: Diuretics ... hyperaldosteronism • High PRA: Renal ... Diagnosis #Algorithm #Nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... , Medications (diuretics ... Primary polydipsia, Low ... Algorithm #diagnosis #sodium ... #nephrology