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Hyponatremia Differential Diagnosis Algorithm

By Dr. Khudhur Mohammed @khudhur_moh

#Hyponatremia #Differential #Diagnosis #Algorithm #sodium #nephrology
Hyponatremia Differential ... Diagnosis Algorithm ... #Differential #Diagnosis ... #Algorithm #sodium ... #nephrology
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
examination, check urine sodium ... acid: - Urine sodium ... - Urine sodium ... Differential #Algorithm #Diagnosis ... #Nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... • nephrotic syndrome ... #Diagnosis #Workup ... #Algorithm #Nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... cirrhosis, nephrotic syndrome ... , CNS Disease, Meds ... UnremarkableLab #Hyponatremia ... #nephrology #sodium
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic Hyponatremia ... Cirrhosis, Nephrotic syndrome ... #Algorithm #diagnosis ... #sodium #nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Osmolarity 3) Urine Sodium ... #Algorithm #nephrology ... #sodium #low #uricacid
Hyponatremia Differential Diagnosis Table

 • Step 1: Correct for hyperglycemia. Corrected Na = [(glucose - 100)/
Hyponatremia Differential ... Diagnosis Table ... #Differential #Diagnosis ... #Table #nephrology ... #sodium
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis ... , Cushing syndrome ... #Differential #Diagnosis ... Workup #Algorithm #nephrology ... #sodium
Algorithm for the diagnosis of hyponatremia.

If you start with the osmolalities, urinary sodium etc first and
Algorithm for the diagnosis ... of hyponatremia ... osmolalities, urinary sodium ... the end you are more ... #Diagnosis #Hyponatremia
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Cirrhosis, Nephrotic syndrome ... SatyaPatelMD #Volume #Hyponatremia ... #algorithm #diagnosis ... #sodium #low #nephrology