20 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... mmol/L - true hyponatremia ... renal failure #Hypernatremia ... #Algorithm #Nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... polydipsia Hypervolemic ... SatyaPatelMD #Volume #Hyponatremia ... #algorithm #diagnosis ... #sodium #low #nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... salt wasting By Rachel ... Stern MD #Hyponatremia ... #nephrology #sodium
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Hyponatremia: Hyperglycemia ... (UOsm < 100): Primary ... polydipsia, Low ... #sodium #nephrology
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
True Hyponatremia ... and serum uric ... and hypervolemic hyponatremia ... low in euvolemic hyponatremia ... kidney_boy #True #Hyponatremia
Diagnostic Approach to Hyponatremia
Box A:
 • Normo/hyperosmolar Hyponatremia: Glucose, Mannitol, Glycine, Contrast media, Maltose
 • Pseudohyponatremia:
Diagnostic Approach to Hyponatremia ... Normo/hyperosmolar Hyponatremia ... Polydipsia, Low ... Wilkinsonjonny #Hyponatremia ... #workup
Primary Polydipsia
Definition: Excessive volitional water intake
Epidemiology:
 • 6-20% of patients with psychiatric disorders - Most commonly
Primary Polydipsia ... • Symptomatic hyponatremia ... with symptomatic hyponatremia ... Osm, Serum Sodium ... #management #nephrology
Hypernatremia Differential Diagnosis Algorithm - Diabetes Insipidus Workup

Step #1 - Consider the history
Step #2 - Assess
Hypernatremia Differential ... Diagnosis Algorithm ... Diabetes Insipidus Workup ... DrEricStrong #Hypernatremia ... #Sodium #nephrology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Vasopressin-independent - Consider: Primary ... polydipsia, Low ... @NephroMD #hyponatremia ... #causes #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... Solute Intake - Primary ... Polydipsia ... UnremarkableLab #Hyponatremia ... #sodium