27 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
HYPOVOLEMIC • extra-renal ... - fevers • renal ... • nephrotic syndrome ... • renal failure ... Diagnosis #Workup #Algorithm
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... • Renal Failure ... Hypovolemic - GI losses, renal ... #causes #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Syndrome of Inappropriate ... Pain/Post-op • Neurologic ... GI losses • Renal ... Hypothyroidism • Adrenal
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Syndrome of Inappropriate ... Pain/Post-op • Neurologic ... GI losses • Renal ... Hypothyroidism • Adrenal
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... UNa > 20: • Renal ... Bicarbonaturia with renal ... Cerebral salt wasting ... Acute or chronic renal
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Na <20: Extra-renal ... Urine Na >30: Renal ... Cirrhosis, Nephrotic syndrome ... Urine Na > 30: Renal ... #algorithm #diagnosis
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... Cirrhosis, Nephrotic syndrome ... Hypothyroidism, Adrenal ... Cerebral salt wasting ... #sodium #nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... High Uric Acid → renal ... salt wasting By ... #nephrology #sodium
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... ≥100): SIADH, Renal ... Present (Uosm <100): Renal ... Hypervolemia with poor renal ... Cirrhosis, Nephrotic syndrome
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... mOsm/kg - Implies renal ... , Ingestion Renal ... , Cushing syndrome ... #nephrology #sodium