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Classification, Differential Diagnosis, and Features of Hyponatremia According to Volume Status 

Hypervolemic hypernatremia 
 - CHF
and Features of Hyponatremia ... Hypervolemic hypernatremia ... - Nephrotic syndrome ... Drugs - SIADH Renal ... Diagnosis #Table #Causes
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Diagnosis Algorithm Syndrome ... Pain/Post-op • Neurologic ... GI losses • Renal ... • Nephrotic syndrome
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Diagnosis Algorithm Syndrome ... Pain/Post-op • Neurologic ... GI losses • Renal ... • Nephrotic syndrome
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... UNa > 20: • Renal ... Cardiac failure #Hyponatremia ... Diagnosis #Algorithm #Causes ... #nephrology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Tea and Toast Syndrome ... • Renal Failure ... Diagnosis #Algorithm #causes ... #nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... • nephrotic syndrome ... • renal failure ... #Hypernatremia ... Workup #Algorithm #Nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... treat underlying cause ... cirrhosis, nephrotic syndrome ... , CNS Disease, Meds ... Algorithm #diagnosis #nephrology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... solute intake, Renal ... @NephroMD #hyponatremia ... differential #algorithm #causes ... #nephrology
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... perspiration Renal ... administration #Hypernatremia ... Differential #Diagnosis #Causes ... #nephrology #sodium
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Na <20: Extra-renal ... Cirrhosis, Nephrotic syndrome ... SatyaPatelMD #Volume #Hyponatremia ... #sodium #low #nephrology