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 ... Diagnosis #Causes #nephrology ... #sodium #high
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Salt Wasting vs SIADH ... Neurological event 2) Sodium ... ) Naturiesis → diuresis ... #SaltWasting #SIADH ... #hyponatremia #
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... volume loss - diuretics ... EUVOLEMIC • SIADH ... Workup #Algorithm #Nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
• Hypovolemic: Diuretics ... osmotic (solute) diuresis ... insipidus (central or nephrogenic ... Workup #Algorithm #nephrology ... #sodium
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
restriction alone in SIADH ... Present (Uosm ≥100): SIADH ... , Renal Sodium loss ... diagnosis #table #sodium ... #nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... OFF (UNa > 30): SIADH ... , Medications (diuretics ... Algorithm #diagnosis #sodium ... #nephrology
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
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
irrigation • Management ... nephrotic syndrome • Hyponatremia ... Lithium-induced nephrogenic ... and euvolemic hyponatremia ... #Nephrology #Pharmacology
Management of Hyponatremia
Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125
Give
Management of Hyponatremia ... Add Diuretics, Consider ... Normalizes in SIADH ... • IF SIADH — ... #treatment #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