15 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... • psychogenic polydipsia ... #Diagnosis #Workup ... #Algorithm #Nephrology
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
Differential Algorithm ... low, uric acid ... and uric acid low ... #Differential #Algorithm ... #Diagnosis #Nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... 100): Primary polydipsia ... , Low solute intake ... #Algorithm #diagnosis ... #sodium #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis ... Workup Algorithm ... • Euvolemic (Low ... #Workup #Algorithm ... #nephrology #sodium
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Hypothyroidism, Low ... deficiency, Primary polydipsia ... #algorithm #diagnosis ... #sodium #low #nephrology
Diagnostic Approach to Hyponatremia
Box A:
 • Normo/hyperosmolar Hyponatremia: Glucose, Mannitol, Glycine, Contrast media, Maltose
 • Pseudohyponatremia:
Diagnostic Approach ... Box C: Primary Polydipsia ... , Low Na intake, ... #Diagnosis #Algorithm ... #workup
Hypernatremia Differential Diagnosis Algorithm - Diabetes Insipidus Workup

Step #1 - Consider the history
Step #2 - Assess
Hypernatremia Differential ... Diagnosis Algorithm ... Diabetes Insipidus Workup ... #Management #Algorithm ... #Sodium #nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Uric Acid - Low ... #Algorithm #nephrology ... #sodium #low #uricacid
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... Consider: Primary polydipsia ... , Low solute intake ... #nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Potomania, Psychogenic polydipsia ... MH/CCF/CWRU EM ... #diagnosis #causes ... #nephrology #sodium ... #low