15 results
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... water retention 1) ... Serum Osmolarity 2) ... Uric Acid → SIADH ... #nephrology #sodium
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Workup Algorithm ... 1) Check Urine ... renal mechanism 2) ... • Euvolemic (Low ... #nephrology #sodium
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Workup Step 1 ... Repeat the sodium ... Step 2. ... EUVOLEMIC • SIADH ... Diagnosis #Workup #Algorithm
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... : Hypovolemia, Heart ... OFF (UNa > 30): SIADH ... Primary polydipsia, Low ... #sodium #nephrology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
: Hypovolemia, Heart ... Inappropriate - Consider: SIADH ... Primary polydipsia, Low ... #diagnosis #differential ... #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
uric acid <4 • SIADH ... Hypothyroidism, Low ... Urine Na < 20: Heart ... #algorithm #diagnosis ... #sodium #low #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... +K / serum Na >1 ... renal perfusion (Heart ... #differential # ... #nephrology
Hypernatremia Differential Diagnosis Algorithm - Diabetes Insipidus Workup

Step #1 - Consider the history
Step #2 - Assess
Hypernatremia Differential ... Diagnosis Algorithm ... Workup Step #1 ... history Step #2 ... #Sodium #nephrology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Beer Potomania - Low ... insufficiency, SIADH ... Hypervolemic - Heart ... #causes #nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Hyponatremia - Differential ... • Euvolemia: SIADH ... Hypervolemia: Congestive Heart ... #causes #nephrology ... #sodium #low