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Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Consider: Primary polydipsia ... , Low solute intake
Diagnostic Approach to Hyponatremia Box A: • Normo/hyperosmolar Hyponatremia: Glucose, Mannitol, Glycine, Contrast media, Maltose • Pseudohyponatremia:
Box C: Primary Polydipsia ... , Low Na intake,
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
Hypothyroidism, Low ... deficiency, Primary polydipsia ... diagnosis #sodium #low
Causes of Polyuria - Differential Diagnosis Excess Intake of Water: • Primary polydipsia (a.k.a. "psychogenic polydipsia") •
Water: • Primary polydipsia ... "psychogenic polydipsia ... • Central Dl (Low
Polyuria - Differential Diagnosis Algorithm Polyuria = >3L Urine output / 24 hours Urine osmolality = 2 (Na
nutrition), Azotemia LOW ... Insipidus • Primary Polydipsia
Hyponatremia - Differential Diagnosis Algorithm ADH Independent: • Tea and Toast Syndrome, Beer Potomania - Low solute
Beer Potomania - Low ... • Psychogenic Polydipsia
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
100): Primary polydipsia ... , Low solute intake
Increased Urination - Differential Diagnosis Framework - Increased Volume / Frequency • Increased osmotic load (Increased
urine (usually low ... Increased intake (low ... osm): Primary Polydipsia
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
can be high or low ... intake (Primary polydipsia ... ), Low solute intake
Diabetic Ketoacidosis (DKA) - Pathogenesis and Clinical Findings • Note: in DKA, body K+ is lost
produces them when low ... precipitant. 5) treat low ... Complications: • Polydipsia
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