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diagnosis differential management nephrology algorithm clinical pharmacology pathophysiology rheumatology causes treatment pulmonary cardiology hyponatremia pocus table radiology comparison hepatology sodium
Causes of Hyponatremia - Differential Diagnosis Algorithm Hypovolemia, UNa > 20: • Renal losses, Diuretic excess,
Hypovolemia, UNa ... Hypovolemia, UNa ... Trauma Euvolemia, UNa ... Hypervolemia, UNa ... Hypervolemia, UNa
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Vasopressin-Dependent • UNa ... Cirrhosis • UNa
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
- RAAS ON (UNa ... - RAAS OFF (UNa
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
algorithm Urine Na ... +K / serum Na >1 ... or Ineffective (UNa ... solute intake, UNa
Hyponatremia - Diagnostic Evaluation Algorithm Step 1: Consider whether Posm may actually be normal or elevated Step 2:
status and measure UNa
Visualizing Hypotonic Hyponatremia • UNa reveals RAAS activity. • UOsm reveals ADH activity. • ADH secretion
Hyponatremia • UNa
Management of SIADH Treat underlying cause: • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
• With lower Na ... osmolality < 538 AND UNa
Urinalysis & Urine Sodium Theophilus Protospatharius, a seventh-century physician who wrote the first manuscript focused exclusively
of Sodium (FE Na ... [(U Na x P Cr) / ... (P Na x U Cr)] ... = Creatinine, Na ... leucocyte-esterase #urine #UNa
SIADH Treatment Options 1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
• With lower Na ... osmolality < 538 AND UNa ... Re-check the serum Na
Hyponatremia (<135 mEq/L) is a common electrolyte abnormality caused by an excess of total body water
concentration (UNa ... intravascular volume; UNa ... SIADH #Thiazides #UNAa
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