34 results
Pathophysiology Based Approach to Hyponatremia - Diagnostic Algorithm

Not the "classic" Volume based approach. 

#Hyponatremia #Algorithm #Pathophysiology
Pathophysiology ... Based Approach to Hyponatremia ... #Hyponatremia #Algorithm ... #Pathophysiology ... Nephrology #UOsm #Osmolality
Hyponatremia (<135 mEq/L) is a common electrolyte abnormality caused by an excess of total body water
Hyponatremia (<135 ... asymptomatic to seizures ... urea causes the hyponatremia ... True hyponatremia ... #hyponatremia #ADH
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Utilizing Uric Acid ADH ... retention 1) Serum Osmolarity ... 2) Urine Osmolarity ... Rachel Stern MD #Hyponatremia
Thiazide induced Hyponatremia - Pathophysiology
 • Reduced distal delivery
 • Inhibition of the NCC (dilution capcity)-
Thiazide induced Hyponatremia ... - Pathophysiology ... permeability increased - ADH ... independent / ADH ... #Pathophysiology
Hyponatremia - Diagnosis and Treatment
Hyponatremia is usually caused by the inability to excrete water normally.
majority of cases, ADH ... Calculate serum osmolality ... 2) Is ADH elevated ... Measure urine osmolality ... of symptomatic (seizures
Hyponatremia Diagnostic Algorithm
1) Check serum osmolality
2) Check urine osmolality
3) ADH Dependent - Check volume status, urine
Hyponatremia Diagnostic ... 1) Check serum osmolality ... 2) Check urine osmolality ... 3) ADH Dependent ... @kidney_boy #Hyponatremia
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Wasting vs SIADH - Pathophysiology ... Hypovolaemia → ADH ... SaltWasting #SIADH #Pathophysiology ... diagnosis #nephrology #hyponatremia
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Saline: • If Urine osmolality ... antagonists: • Blocks ADH ... SIADH #Management #hyponatremia
Anticonvulsants as Mood Stabilizers: Mechanism and Side-effect
Examples: Valproate, Carbamazepine, Lamotrigine
 • Mild anticholinergic effect -> Drowsiness
-> Withdrawal seizure ... vomiting, diarrhea, hyponatremia ... #SideEffects #Pathophysiology
SIADH Treatment Options
1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
NS • If Urine osmolality ... vaptans) • Blocks ADH ... SIADH #Management #hyponatremia