63 results
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
• Euvolemic (Low ... insipidus (central or nephrogenic ... Hypervolemic: Conn syndrome ... , Cushing syndrome ... Algorithm #nephrology #sodium
Classification, Differential Diagnosis, and Features of Hyponatremia According to Volume Status 

Hypervolemic hypernatremia 
 - CHF
and Features of Hyponatremia ... Hypervolemic hypernatremia ... - Nephrotic syndrome ... Acute and chronic kidney ... Normovolemic hyponatremia
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
examination, check urine sodium ... acid: - Urine sodium ... low, uric acid ... - Urine sodium ... and uric acid low
Inherited Defects in Kidney Tubule Epithelial Cells

Renal glucosuria - Na+-dependent glucose cotransporter
Cystinuria - Amino acid transporter
Bartter
Inherited Defects in Kidney ... cell epithelial sodium ... of epithelial sodium ... -2 deficiency Nephrogenic ... Inherited #Defects #Kidney
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... insipidus • Nephrogenic ... administration #Hypernatremia ... Causes #nephrology #sodium
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Osmolarity 3) Urine Sodium ... Uric Acid - Low ... Algorithm #nephrology #sodium ... #low #uricacid
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic Hyponatremia ... Cirrhosis, Nephrotic syndrome ... Primary polydipsia, Low ... Algorithm #diagnosis #sodium
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 ... sensitivity in kidneys ... DrEricStrong #Hypernatremia
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Hypothyroidism, Low ... Cirrhosis, Nephrotic syndrome ... algorithm #diagnosis #sodium ... #low #nephrology