9 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... 1 . ... mmol/L - true hyponatremia ... renal failure #Hypernatremia ... #Algorithm #Nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... Algorithm 1) ... Extrarenal Hypernatremia ... MatthewHoMD #Hypernatremia ... #Algorithm #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
to Hyponatremia ... uric acid <4 • SIADH ... #Hyponatremia # ... algorithm #diagnosis ... #sodium #low #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
Approach to Hypotonic Hyponatremia ... case of hypotonic hyponatremia ... algorithm Urine ... +K / serum Na >1 ... Physiologic #Hypotonic #Hyponatremia
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... water retention 1) ... Uric Acid → SIADH ... Rachel Stern MD #Hyponatremia ... #nephrology #sodium
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Hyponatremia: Hyperglycemia ... irrigants Hypotonic Hyponatremia ... OFF (UNa > 30): SIADH ... Primary polydipsia, Low
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Inappropriate - Consider: SIADH ... Primary polydipsia, Low ... solute intake, ... @NephroMD #hyponatremia
Hyponatremia - Diagnostic Evaluation Algorithm

Step 1: Consider whether Posm may actually be normal or elevated
Step 2:
Hyponatremia - Diagnostic ... Step 1: Consider ... Step 3: Assess volume ... DrEricStrong #Hyponatremia ... #Diagnosis #Workup
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Beer Potomania - Low ... insufficiency, SIADH ... thecurbsiders #Hyponatremia ... #causes #nephrology