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Classification, Differential Diagnosis, and Features of Hyponatremia According to Volume Status 

Hypervolemic hypernatremia 
 - CHF
Classification, ... and Features of Hyponatremia ... - Nephrotic syndrome ... #Classification ... Diagnosis #Table #Causes
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... insipidus • Nephrogenic ... administration #Hypernatremia ... Differential #Diagnosis #Causes ... #nephrology #sodium
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... insipidus (central or nephrogenic ... Hypervolemic: Conn syndrome ... , Cushing syndrome ... Algorithm #nephrology #sodium
Hypernatremia Classification and Features According to Volume Status
 - Hypervolemic hypernatremia - Cushing's syndrome, Primary hyperaldosteronism,
Hypernatremia Classification ... - Hypervolemic hypernatremia ... - Cushing's syndrome ... Gestational DI, Nephrogenic ... #Classification
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... mmol/L - true hyponatremia ... • nephrotic syndrome ... renal failure #Hypernatremia
Etiologies of Hypernatremia - Differential Diagnosis
GI losses / Insensible losses
Sodium Overload
Transcellular Movement of Water
Central Diabetes Insipidus
Etiologies of Hypernatremia ... Insensible losses Sodium ... congenital disorders Nephrogenic ... DrEricStrong #Hypernatremia ... Diagnosis #Table #Causes
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Causes of Hypernatremia ... Diagnosis Algorithm Hypernatremia ... water loss, Serum Sodium ... Hyperventilation #Hypernatremia ... Diagnosis #Algorithm #Causes
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... treat underlying cause ... cirrhosis, nephrotic syndrome ... UnremarkableLab #Hyponatremia ... diagnosis #nephrology #sodium
Acute Kidney Injury - Classification
Prerenal:
 • Dehydration
 • Heart failure (a.k.a. cardiorenal syndrome)
 • Liver failure
Kidney Injury - Classification ... a.k.a. cardiorenal syndrome ... a.k.a. hepatorenal syndrome ... tubular necrosis (causes ... obstruction) • Neurogenic
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic Hyponatremia ... irrigants Hypotonic Hyponatremia ... Cirrhosis, Nephrotic syndrome ... Algorithm #diagnosis #sodium