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Diagnosis and Management of Hypernatremia

#Hypernatremia #Differential #Algorithm #Causes #Nephrology #Diagnosis

** GrepMed Recommended Text: Nephrology Secrets -
of Hypernatremia ... #Hypernatremia ... #Differential #Algorithm ... #Causes #Nephrology ... #Diagnosis *
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
True Hyponatremia ... and hypervolemic hyponatremia ... in euvolemic hyponatremia ... kidney_boy #True #Hyponatremia ... #Diagnosis #Nephrology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... Beer Potomania - Low ... thecurbsiders #Hyponatremia ... #Algorithm #causes
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... mmol/L - true hyponatremia ... • nephrotic syndrome ... renal failure #Hypernatremia ... #Algorithm #Nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Hyponatremia: Hyperglycemia ... Primary polydipsia, Low ... #Algorithm #diagnosis ... #sodium #nephrology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Primary polydipsia, Low ... @NephroMD #hyponatremia ... #algorithm #causes ... #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... Diagnosis Algorithm ... treat underlying cause ... UnremarkableLab #Hyponatremia ... #Algorithm #diagnosis
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... Extrarenal Hypernatremia ... • Euvolemic (Low ... Ingestion Renal Hypernatremia ... MatthewHoMD #Hypernatremia
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Causes of Hypernatremia ... Algorithm Hypernatremia ... mannitol, glucosuria Low ... Hyperventilation #Hypernatremia ... #Diagnosis #Algorithm
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Algorithm Syndrome ... osmole intake #Hyponatremia ... #Nephrology #Differential ... #Diagnosis #Algorithm