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diagnosis differential algorithm causes management alkalosis anticoagulation chloride citrate defects diuresis diuretics epithelial excretion gitelman heat heatstroke hypokalemia hyponatremia hypotonic
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
• Euvolemic (Low ... Hypervolemic: Conn syndrome ... , Cushing syndrome ... Workup #Algorithm #nephrology ... #sodium
Metabolic Alkalosis - Urinary Chloride Algorithm Cl- responsive metabolic alkalosis • Kidney loss of Cl-
alkalosis • Normal/low ... diuretic use, Bartter syndrome ... , Gitelman syndrome ... the excretion of sodium ... urine #Algorithm #nephrology
Inherited Defects in Kidney Tubule Epithelial Cells Renal glucosuria - Na+-dependent glucose cotransporter Cystinuria - Amino acid transporter Bartter
cell epithelial sodium ... of epithelial sodium ... renal tubular acidosis ... Defects #Kidney #Nephrology ... #Differential #Table
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
: SIADH, Renal Sodium ... can be high or low ... Cirrhosis, Nephrotic syndrome ... differential #diagnosis #table ... #sodium #nephrology
Citrate Anticoagulation Toxicity Hypernatremia (HyperNa): - Citrate solutions may have ↑ sodium content and should be paired
Anticoagulation Toxicity Hypernatremia ... solutions may have ↑ sodium ... Acidosis: - Citrate ... dysfunction or low ... Toxicity #toxicology #nephrology
Heat Illnesses and Heat Stroke - Differential Diagnosis Framework Heat Cramps: • Muscle pain or spasm -
Dehydration - Loss of sodium ... conditions - Neurogenic ... heat illness → Hypernatremia ... • Labs: - Metabolic ... consciousness, Coma/seizure
Gitelman Syndrome Overview What? • Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter • Gitelman's syndrome
thiazide-sensitive sodium ... alkalosis • Normal or low ... Renal tubular acidosis ... tachycardia • Seizures ... #diagnosis #nephrology
Diuretics and Agents Regulating Renal Excretion Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide) • Glaucoma • Epilepsy • Altitude
resistance • Metabolic ... • Hyponatremia ... and euvolemic hyponatremia ... Excretion #Diuresis #Nephrology ... #Medications #Table
Rhabdomyolysis - Differential Diagnosis Framework and Management Summary Causes of Rhabdomyolysis: • Trauma: - Immobilization - Crush injury - Compartment
Heat stroke - Metabolic ... exertion/training - Seizures ... Hyperuricemia • Hyponatremia ... per day until stable ... causes #treatment #nephrology
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