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Diagnosis and Management of Hypernatremia

#Hypernatremia #Differential #Algorithm #Causes #Nephrology #Diagnosis

** GrepMed Recommended Text: Nephrology Secrets -
Diagnosis and Management ... #Differential # ... Algorithm #Causes ... #Nephrology #Diagnosis ... Recommended Text: Nephrology
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... - Differential ... insipidus • Nephrogenic ... #Differential # ... #nephrology #sodium
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... - Differential ... Pain/Post-op • Neurologic ... • Reduced GFR, AKI ... #Nephrology #Differential
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... - Differential ... Pain/Post-op • Neurologic ... • Reduced GFR, AKI ... #Nephrology #Differential
Acute Kidney Injury (AKI) - Differential Diagnosis Framework
Pre-Renal:
 • Hypovolemia, Cardiorenal, Distributive Shock, HRS, Hypercalcemia, Renal
Kidney Injury (AKI ... ) - Differential ... Nephrolithiasis) • Neurogenic ... #Diagnosis #nephrology ... #causes #algorithm
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis ... • Euvolemic (Low ... insipidus (central or nephrogenic ... #Differential # ... Workup #Algorithm #nephrology
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Causes of Hypernatremia ... - Differential ... mannitol, glucosuria Low ... #Nephrology #Differential ... Diagnosis #Algorithm #Causes
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Primary polydipsia, Low ... #diagnosis #differential ... #algorithm #causes ... #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... can be high or low ... Primary polydipsia), Low ... #differential # ... table #sodium #nephrology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Beer Potomania - Low ... #Differential # ... Diagnosis #Algorithm #causes ... #nephrology