21 results
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
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
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
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
Hypernatremia - Differential Diagnosis and Treatment
Hypernatremia is almost always due to unreplaced water loss (free water
Hypernatremia - ... and Treatment Hypernatremia ... Diabetes Insipidus: neurogenic ... , nephrogenic 4 ... management #nephrology #sodium
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
Inherited Defects in Kidney Tubule Epithelial Cells

Renal glucosuria - Na+-dependent glucose cotransporter
Cystinuria - Amino acid transporter
Bartter
limb Gitelman syndrome ... cell epithelial sodium ... of epithelial sodium ... exchanger,H+-ATPase Nephrogenic ... -2 deficiency Nephrogenic
Hypernatremia Classification and Features According to Volume Status
 - Hypervolemic hypernatremia - Cushing's syndrome, Primary hyperaldosteronism,
Hypernatremia Classification ... - Hypervolemic hypernatremia ... - Cushing's syndrome ... - Normovolemic hypernatremia ... Gestational DI, Nephrogenic
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Cirrhosis, Nephrotic syndrome ... SatyaPatelMD #Volume #Hyponatremia ... algorithm #diagnosis #sodium
Hyponatremia - Differential Diagnosis by Mechanism
Decr Blood Pressure (“Decr Effective Circulating Volume”) 
 - Volume depletion
Hyponatremia - Differential ... - Cirrhosis Syndrome ... DrEricStrong #Hyponatremia ... Table #Causes #Sodium