25 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... mmol/L - true hyponatremia ... Assess volume status ... renal failure #Hypernatremia ... #Nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Hyponatremia: Hyperglycemia ... Cirrhosis, Nephrotic syndrome ... OFF (UNa > 30): SIADH ... #sodium #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 ... failure Satya Patel ... SatyaPatelMD #Volume #Hyponatremia ... #sodium #low #nephrology
Hypo-osmolar Hypotonic HypoNatremia Algorithm (Serum Na+ < 135 meq/L, serum Osm < 275 mosm/kg)
Assess Volume Status,
Hypo-osmolar Hypotonic HypoNatremia ... Algorithm (Serum ... Assess Volume Status ... Urine Osm #Hyponatremia ... #Nephrology #Differential
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... insufficiency, SIADH ... thecurbsiders #Hyponatremia ... #causes #nephrology
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
True Hyponatremia ... and hypervolemic hyponatremia ... low in euvolemic hyponatremia ... kidney_boy #True #Hyponatremia ... #Diagnosis #Nephrology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... Inappropriate - Consider: SIADH ... @NephroMD #hyponatremia ... #causes #nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Low Uric Acid → SIADH ... Rachel Stern MD #Hyponatremia ... #nephrology #sodium
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... Extrarenal Hypernatremia ... Ingestion Renal Hypernatremia ... MatthewHoMD #Hypernatremia ... #nephrology #sodium
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... cirrhosis, nephrotic syndrome ... , SSRIs) - SIADH ... UnremarkableLab #Hyponatremia ... #diagnosis #nephrology