14 results
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... • Osmotic diuresis ... insipidus • Nephrogenic ... Differential #Diagnosis #Causes ... #nephrology #sodium
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... restriction alone in SIADH ... , Renal Sodium loss ... can be high or low ... #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
• Euvolemic (Low ... • Hypovolemic: Diuretics ... osmotic (solute) diuresis ... Workup #Algorithm #nephrology ... #sodium
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
OFF (UNa > 30): SIADH ... , Medications (diuretics ... Primary polydipsia, Low ... Algorithm #diagnosis #sodium ... #nephrology
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Causes of Hypernatremia ... water loss, Serum Sodium ... administration • Osmotic diuresis ... mannitol, glucosuria Low ... #Nephrology #Differential
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
• Hypovolemia: Diuretics ... • Euvolemia: SIADH ... Algorithm #diagnosis #causes ... #nephrology #sodium ... #low
Hypernatremia - Differential Diagnosis and Treatment
Hypernatremia is almost always due to unreplaced water loss (free water
, Dehydration: neurologic ... unavailable 2) Osmotic Diuresis ... Diabetes Insipidus: neurogenic ... Diagnosis #Treatment #management ... #nephrology #sodium
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... promoting passive sodium ... SatyaPatelMD #SIADH ... #Management #hyponatremia ... #nephrology #treatment
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
irrigation • Management ... nephrotic syndrome • Hyponatremia ... Kidney stones caused ... and euvolemic hyponatremia ... #Nephrology #Pharmacology
Management of Hyponatremia
Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125
Give
Management of Hyponatremia ... Normalizes in SIADH ... • IF SIADH — ... look for cause ... #treatment #sodium