23 results
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Osmolarity 2) Urine ... Uric Acid - Low ... Uric Acid → SIADH ... Diagnosis #Algorithm #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... uric acid <4 • SIADH ... Hypothyroidism, Low ... diagnosis #sodium #low ... #nephrology
Granular & “Muddy Brown” Casts on Urine Microscopy
A. Finely granular cast B. slightly coarser granular cast
“Muddy Brown” Casts ... of mb granular casts ... appreciated at low ... Granular #MuddyBrown #Casts ... #Clinical #Nephrology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Inappropriate - Consider: SIADH ... Primary polydipsia, Low ... differential #algorithm #causes ... #nephrology
Atlas of Urine Microscopy Findings
 • Epithelial cells - Normal
 • Renal tubular cells - Acute
• White cell casts ... infection • Hyaline casts ... disease • Granular casts ... key #diagnosis #nephrology ... #casts
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Beer Potomania - Low ... insufficiency, SIADH ... Diagnosis #Algorithm #causes ... #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... volume-based algorithm Urine ... restriction alone in SIADH ... can be high or low ... table #sodium #nephrology
Simplified Approach to Acute Kidney Injury (AKI)
1) IS THIS AN EMERGENCY? 
Is there a dialysis indication
to Acute Kidney Injury ... : Hypovolemia, Low ... PROBLEM ~80% of AKI cases ... IMPROVEMENT If the urine ... for WBCs, RBCs, casts
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Causes of Hypernatremia ... 145 mmol/L High Urine ... mannitol, glucosuria Low ... Urine Osmolality ... #Nephrology #Differential
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... Saline: • If Urine ... SatyaPatelMD #SIADH ... #Management #hyponatremia ... #nephrology #treatment