21 results
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
algorithm Urine ... or Ineffective (UNa ... , Renal Sodium loss ... #differential #diagnosis ... #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Volume Based Approach ... to Hyponatremia ... uric acid <4 • SIADH ... algorithm #diagnosis ... #sodium #low #nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... > 30): SIADH, Medications ... polydipsia, Low solute ... #Algorithm #diagnosis ... #sodium #nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... EUVOLEMIC • SIADH ... #Diagnosis #Workup ... #Algorithm #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 ... Pathophysiology #diagnosis ... #nephrology #hyponatremia
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... Inappropriate - Consider: SIADH ... polydipsia, Low solute ... #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... Hypovolemic - Give volume ... , SSRIs) - SIADH ... #Algorithm #diagnosis ... #nephrology #sodium
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Osmolarity 3) Urine Sodium ... Low Uric Acid → SIADH ... #Algorithm #nephrology
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
Differential Algorithm ... in addition) of volume ... - Urine sodium ... #Differential #Algorithm ... #Diagnosis #Nephrology
Hyponatremia - Diagnostic Evaluation Algorithm

Step 1: Consider whether Posm may actually be normal or elevated
Step 2:
Hyponatremia - Diagnostic ... Evaluation Algorithm ... Step 3: Assess volume ... status and measure UNa ... tests Step 5: If SIADH