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diagnosis differential causes management algorithm alkalosis anticoagulation chloride citrate classification diuresis diuretics elevation excretion gitelman heat heatstroke hypokalemia hyponatremia illness
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
Hyponatremia - Diagnosis and Treatment Hyponatremia is usually caused by the inability to excrete water normally.
Treatment: Treatment ... demyelination syndrome ... of symptomatic (seizures ... #management #nephrology ... #sodium
Gitelman Syndrome Overview What? • Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter • Gitelman's syndrome
alkalosis • Normal or low ... Renal tubular acidosis ... tachycardia • Seizures ... Rhabdomyolysis Treatment ... #diagnosis #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
Diuretics and Agents Regulating Renal Excretion Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide) • Glaucoma • Epilepsy • Altitude
resistance • Metabolic ... • Hyponatremia ... Tolvaptan) • Treatment ... and euvolemic hyponatremia ... Excretion #Diuresis #Nephrology
Rhabdomyolysis - Differential Diagnosis Framework and Management Summary Causes of Rhabdomyolysis: • Trauma: - Immobilization - Crush injury - Compartment
- Compartment syndrome ... Heat stroke - Metabolic ... exertion/training - Seizures ... Hyperuricemia • Hyponatremia ... #nephrology
Causes of Lactate Elevation, Lactic Acidosis - Differential Diagnosis The most common causes of hyperlactatemia are usually:
impairment of cellular metabolism ... sweat) - its metabolism ... before beginning treatment ... LV failure - Low ... - Compartment syndrome
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