81 results
Hypernatremia - Differential Diagnosis and Treatment
Hypernatremia is almost always due to unreplaced water loss (free water
, Dehydration: neurologic ... Diabetes Insipidus: neurogenic ... , nephrogenic 4 ... #management #nephrology ... #sodium
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
insipidus (central or nephrogenic ... Hypervolemic: Conn syndrome ... , Cushing syndrome ... Workup #Algorithm #nephrology ... #sodium
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... insipidus • Nephrogenic ... administration #Hypernatremia ... Diagnosis #Causes #nephrology ... #sodium #high
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 ... Inherited #Defects #Kidney ... #Nephrology #Diagnosis
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 ... Workup #Algorithm #Nephrology
Hypernatremia Differential Diagnosis Algorithm - Diabetes Insipidus Workup

Step #1 - Consider the history
Step #2 - Assess
Hypernatremia Differential ... DrEricStrong #Hypernatremia ... #Management #Algorithm ... #Sodium #nephrology
Hypernatremia Management Algorithm
Acute vs Chronic
Calculate Losses
 • Current water Deficit
 • Ongoing Free water Losses
 •
Hypernatremia Management ... Medicine @SCVMCMed #Hypernatremia ... #Management #Algorithm ... #treatment #nephrology
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
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic Hyponatremia ... Cirrhosis, Nephrotic syndrome ... Algorithm #diagnosis #sodium ... #nephrology
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
irrigation • Management ... • Hyponatremia ... Tolvaptan) • Treatment ... and euvolemic hyponatremia ... Excretion #Diuresis #Nephrology