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Rhabdomyolysis - Differential Diagnosis Framework and Management Summary

Causes of Rhabdomyolysis:
 • Trauma:
	- Immobilization
	- Crush injury
	- Compartment
Rhabdomyolysis - Differential ... Shift of extracellular ... Treatment of underlying ... Rhabdomyolysis #Differential ... #nephrology
Causes of Hypokalemia
Transcellular Shifts:
 - Alkalosis, Increased plasma insulin (treatment of diabetic ketoacidosis), ß-Adrenergic agonists, Hypokalemic
Transcellular Shifts ... plasma insulin (treatment ... Villous adenoma Renal ... Hypokalemia #Causes #differential ... #diagnosis #nephrology
Hypokalemia - Differential Diagnosis Algorithm

Transcellular Shift:
 • Alkalosis
 • ↑ beta-2 adrenergic simulation 
 • Erythropoiesis
Hypokalemia - Differential ... Transcellular Shift ... Medications Renal ... Losses Non-renal ... Diagnosis #Algorithm #nephrology
Hypophosphatemia - Differential Diagnosis Algorithm
 • Decreased intake/absorption: Starvation, Alcoholism, Malabsorption, Phosphate binder use
 • Redistribution/
Hypophosphatemia - Differential ... Redistribution/ Shift ... bone syndrome • Renal ... Hypophosphatemia #Differential ... Algorithm #causes #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 ... Hypomagnesemia #algorithm #differential ... diagnosis #causes #nephrology
Causes of Hyperkalemia - Differential Diagnosis Algorithm
 • Increased Intake
 • Reduced Excretion (IV potassium with
Hyperkalemia - Differential ... Transcellular Shift ... #Hyperkalemia #Nephrology ... #Differential #
Hypokalemia Differential Algorithm
Acidosis
 - RTA
 - Diarrhea
pH Normal 
 1. Decreased Mg 
 2. Intracellular Shift
Hypokalemia Differential ... Intracellular Shift ... Renal artery stenosis ... #Hypokalemia #Differential ... Causes #Workup #Nephrology
Workup for Hyperphosphatemia - Differential Diagnosis Framework
Rule out spurious hyperphosphatemia: paraproteinemia, hyperlipidemia, hemolysis, hyperbilirubinemia, liposomal amphotericin
Hyperphosphatemia - Differential ... Transcellular Shift ... CKD Increased Renal ... Hyperphosphatemia #Differential ... Workup #phosphate #nephrology
Hyperkalemia Treatment Options
Stabilize cardiac membrane:
 • IV Calcium (peaks 5-10 minutes)
Decrease potassium concentration:
 • IV Fluids
Shift
Hyperkalemia Treatment ... • IV Fluids Shift ... (if preserved renal ... management #potassium #nephrology
Hypokalemia Differential Diagnosis Algorithm

Low intake 
• poor oral intake 

Renal loss 
• Medication 
• Hypomagnesemia 
•
Hypokalemia Differential ... oral intake Renal ... Nonreabsorbable anions • Renal ... Transcellular shift ... #Hypokalemia #Differential