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Hypokalemia - Differential Diagnosis Algorithm Transcellular Shift: • Alkalosis • ↑ beta-2 adrenergic simulation • Erythropoiesis
Transcellular Shift ... • Refeeding syndrome ... Medications Renal ... Losses Non-renal ... Diagnosis #Algorithm #nephrology
Hypophosphatemia - Differential Diagnosis Algorithm • Decreased intake/absorption: Starvation, Alcoholism, Malabsorption, Phosphate binder use • Redistribution/
Redistribution/ Shift ... ), Hungry bone syndrome ... • Renal losses ... Algorithm #causes #nephrology
Hypokalemia Differential Diagnosis Algorithm Low intake • poor oral intake Renal loss • Medication • Hypomagnesemia •
oral intake Renal ... Nonreabsorbable anions • Renal ... • Gitelman's syndrome ... • Bartter's syndrome ... Transcellular shift
Workup for Hyperphosphatemia - Differential Diagnosis Framework Rule out spurious hyperphosphatemia: paraproteinemia, hyperlipidemia, hemolysis, hyperbilirubinemia, liposomal amphotericin
Rhabdomyolysis, Tumor lysis syndrome ... Transcellular Shift ... CKD Increased Renal ... Workup #phosphate #nephrology
Cardiorenal Syndrome (CRS) Types • Type 1 - Acute CRS: Alteration of renal perfusion is the
Cardiorenal Syndrome ... Alteration of renal ... hemodialysis and fluids shifts ... #Cardiorenal #Syndrome ... Types #cardiology #nephrology
Hypokalemia - Differential Diagnosis Algorithm Extra-renal Losses: • Normal Acid-Base: Low intake • Metabolic acidosis: Gl tract
Algorithm Extra-renal ... loss (Diarrhea) Renal ... SAME, Cushing Syndrome ... , Gitelman syndrom ... potassium #low #nephrology
Drugs associated with hypokalemia and hypomagnesemia Hypokalemia - Shift from extracellular fluid to intracellular fluid compartment -
Hypokalemia - Shift ... Extrarenal Laxatives - Renal ... pump inhibitor - Renal ... Fanconi syndrome ... differential #diagnosis #nephrology
Workup for Hypophosphatemia - Differential Diagnosis Framework Rule out spurious hypophosphatemia: paraproteinemia, acute leukemia Measure Urine Fractional Excretion
Transcellular Shift ... Tumor genesis syndrome ... FEPO4 ≥ 5% - Renal ... FGF-23: Fanconi syndrome ... Workup #phosphate #nephrology
Localization of Renal Tubular Defects Fanconi Syndrome: Proximal tubule Bartter Syndrome: Thick ascending loop of Henle Gitelman Syndrome: Distal
Localization of Renal ... Defects Fanconi Syndrome ... tubule Bartter Syndrome ... Henle Gitelman Syndrome ... Pathophysiology #Nephrology
Approach to Hypomagnesemia Fractional excretion of magnesium = (urine magnesium x serum creatinine)/ [0.7 (serum magnesium
intake, Gl loss, shift ... cells FEMg >4% = renal ... magnesium loss if renal ... diagnosis #causes #nephrology
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