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Hyponatremia Differential Diagnosis Algorithm

By Dr. Khudhur Mohammed @khudhur_moh

#Hyponatremia #Differential #Diagnosis #Algorithm #sodium #nephrology
Hyponatremia Differential ... Diagnosis Algorithm ... #Differential #Diagnosis ... #Algorithm #sodium ... #nephrology
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
examination, check urine sodium ... acid: - Urine sodium ... - Urine sodium ... Differential #Algorithm #Diagnosis ... #Nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... • nephrotic syndrome ... #Diagnosis #Workup ... #Algorithm #Nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic Hyponatremia ... Cirrhosis, Nephrotic syndrome ... #Algorithm #diagnosis ... #sodium #nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Osmolarity 3) Urine Sodium ... #Algorithm #nephrology ... #sodium #low #uricacid
Hyponatremia Differential Diagnosis Table

 • Step 1: Correct for hyperglycemia. Corrected Na = [(glucose - 100)/
Hyponatremia Differential ... Diagnosis Table ... #Differential #Diagnosis ... #Table #nephrology ... #sodium
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis ... , Cushing syndrome ... #Differential #Diagnosis ... Workup #Algorithm #nephrology ... #sodium
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... Diagnosis Algorithm ... cirrhosis, nephrotic syndrome ... UnremarkableLab #Hyponatremia ... #nephrology #sodium
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Cirrhosis, Nephrotic syndrome ... SatyaPatelMD #Volume #Hyponatremia ... #algorithm #diagnosis ... #sodium #low #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... - Differential Diagnosis ... Algorithm Syndrome ... Pain/Post-op • Neurologic ... • Nephrotic syndrome