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diagnosis differential nephrology causes hyponatremia management algorithm defects ebv epithelial heat heatstroke hypotonic hypovolemia illness inherited kidney osmolality pathophysiology physiologic
Gitelman Syndrome Overview What? • Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter • Gitelman's syndrome
Gitelman Syndrome ... thiazide-sensitive sodium ... alkalosis • Normal or low ... Renal tubular acidosis ... tachycardia • Seizures
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
: • ADH ON (UOsm ... ON (UNa < 30): Hypovolemia ... Cirrhosis, Nephrotic syndrome ... Primary polydipsia, Low ... Algorithm #diagnosis #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 ... Insipidus (Decr ADH ... hypercalcemia - Chronic hypokalemia ... Differential #Diagnosis #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 ... Present (Uosm ≥100): Hypovolemia ... Cirrhosis, Nephrotic syndrome ... differential #diagnosis #table
Inherited Defects in Kidney Tubule Epithelial Cells Renal glucosuria - Na+-dependent glucose cotransporter Cystinuria - Amino acid transporter Bartter
ascending limb Gitelman ... cell epithelial sodium ... of epithelial sodium ... renal tubular acidosis ... #Differential #Table
Hyponatremia (<135 mEq/L) is a common electrolyte abnormality caused by an excess of total body water
asymptomatic to seizures ... stimulated in states of low ... activated in states of low ... #hyponatremia #ADH ... #RAAS #Hypovolemia
Heat Illnesses and Heat Stroke - Differential Diagnosis Framework Heat Cramps: • Muscle pain or spasm -
Dehydration - Loss of sodium ... conditions - Neurogenic ... heat illness → Hypernatremia ... consciousness, Coma/seizure ... - Hyperkalemia
Rhabdomyolysis - Differential Diagnosis Framework and Management Summary Causes of Rhabdomyolysis: • Trauma: - Immobilization - Crush injury - Compartment
- Compartment syndrome ... exertion/training - Seizures ... Aldolase ↑ • LDH ... Hyperuricemia • Hyponatremia ... per day until stable
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