86 results
Central vs Nephrogenic Diabetes Insipidus - Desmopressin Challenge
Give desmopressin (intranasal, SQ, IV) and monitor UOsm every
Central vs Nephrogenic ... BostonChiefs #Central #Nephrogenic
Polyuria - Differential Diagnosis
Solute Diuresis
 • Na intake/saline
 • Glucosuria: Hyperglycemia, SGLT-2 inhibitors
 • Urea: Exogenous
• Central DI, Nephrogenic
Inherited Defects in Kidney Tubule Epithelial Cells

Renal glucosuria - Na+-dependent glucose cotransporter
Cystinuria - Amino acid transporter
Bartter
exchanger,H+-ATPase Nephrogenic ... -2 deficiency Nephrogenic
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
insipidus • Nephrogenic
Polyuria - Differential Diagnosis Algorithm
Urine Output > 3L /day
Water Diuresis (Urine Osm <100 mOsm/kg)
 • Primary
Insipidus • Nephrogenic
Classification of Diabetes Insipidus

Central or neurogenic diabetes insipidus:
 - Congenital - Structural malformations affecting the hypothalamus
Central or neurogenic ... Surgery, Idiopathic Nephrogenic
Etiologies of Hypernatremia - Differential Diagnosis
GI losses / Insensible losses
Sodium Overload
Transcellular Movement of Water
Central Diabetes Insipidus
congenital disorders Nephrogenic
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
insipidus (central or nephrogenic
Hypernatremia Classification and Features According to Volume Status
 - Hypervolemic hypernatremia - Cushing's syndrome, Primary hyperaldosteronism,
Gestational DI, Nephrogenic
Causes of Polyuria - Differential Diagnosis Algorithm
Polyuria - Urine Output > 3L/day, Increased Urine Volume (>2ml/min)
Osmotic
Kidney • Nephrogenic