30 results
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... concentrating defect: • Diuretics ... • Osmotic diuresis ... insipidus • Nephrogenic ... Causes #nephrology #sodium
Hypernatremia Classification and Features According to Volume Status
 - Hypervolemic hypernatremia - Cushing's syndrome, Primary hyperaldosteronism,
- Cushing's syndrome ... Gestational DI, Nephrogenic ... - Osmotic diuretic ... , Loop diuretics ... Postobstructive diuresis
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
• Hypovolemic: Diuretics ... osmotic (solute) diuresis ... Hypervolemic: Conn syndrome ... , Cushing syndrome ... Algorithm #nephrology #sodium
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
disequilibrium syndrome ... and nephrotic syndrome ... • Hyponatremia ... • Nephrogenic ... and euvolemic hyponatremia
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 ... volume loss - diuretics ... • nephrotic syndrome
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic Hyponatremia ... Cirrhosis, Nephrotic syndrome ... , Medications (diuretics ... Algorithm #diagnosis #sodium
Hypernatremia - Differential Diagnosis and Treatment
Hypernatremia is almost always due to unreplaced water loss (free water
unavailable 2) Osmotic Diuresis ... Diabetes Insipidus: neurogenic ... , nephrogenic 4 ... risk for cerebral edema ... management #nephrology #sodium
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Wasting vs SIADH - Pathophysiology ... Neurological event 2) Sodium ... ) Naturiesis → diuresis ... SaltWasting #SIADH #Pathophysiology ... diagnosis #nephrology #hyponatremia
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
Approach to Hypotonic Hyponatremia ... : SIADH, Renal Sodium ... loss (diuretics ... Cirrhosis, Nephrotic syndrome ... diagnosis #table #sodium
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Diagnosis Algorithm Syndrome ... especially thiazide diuretics ... ) With edema ... • Nephrotic syndrome