13 results
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
- RAAS ON (UNa ... - RAAS OFF (UNa ... > 30): SIADH, Medications ... #diagnosis #sodium ... #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... or Ineffective (UNa ... , Renal Sodium loss ... solute intake, UNa ... #nephrology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis Algorithm ... Vasopressin-Dependent • UNa ... Cirrhosis • UNa ... Inappropriate - Consider: SIADH ... #causes #nephrology
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... pain, primary lung ... promoting passive sodium ... SatyaPatelMD #SIADH ... #hyponatremia #nephrology
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Salt Wasting vs SIADH ... Neurological event 2) Sodium ... reabsorption 5) ↓ Na ... #SaltWasting #SIADH ... Pathophysiology #diagnosis #nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Differential Diagnosis Algorithm ... Osmolarity 3) Urine Sodium ... Low Uric Acid → SIADH ... Differential #Diagnosis #Algorithm ... #nephrology #sodium
SIADH Treatment Options
1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... Pain, Primary lung ... promoting passive sodium ... osmolality < 538 AND UNa ... #hyponatremia #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
acid >4 • Urine Na ... uric acid <4 • SIADH ... #Hyponatremia #algorithm ... #diagnosis #sodium ... #low #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Differential Diagnosis Algorithm ... , SSRIs) - SIADH ... Differential #Diagnosis #Algorithm ... #diagnosis #nephrology ... #sodium
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Repeat the sodium ... EUVOLEMIC • SIADH ... Diagnosis #Workup #Algorithm ... #Nephrology